CISRS Handbook - San Diego Workforce Partnership

Transcription

CISRS WIA Forms & Procedures
Handbook
A Guide to Information Tracked in the
Customer Information Services Reporting System
(CISRSSM)
May 2010
CISRS Forms and Procedures Handbook
1
May 2010
Table of Contents
Introduction ----------------------------------------------------------------------------------------------------------- 11
Chapter 1 -------------------------------------------------------------------------------------------------------------- 13
Membership Application Form ---------------------------------------------------------------------------------------------- 13
Introduction and Purpose .......................................................................................................................... 13
1 Application Number .............................................................................................................................. 16
2 Membership Date .................................................................................................................................. 16
3 Last Name ............................................................................................................................................ 16
4 First Name ............................................................................................................................................ 16
5 Middle Name ........................................................................................................................................ 16
6 Social Security Number ......................................................................................................................... 16
7 Birth Date ............................................................................................................................................. 16
8 Age ...................................................................................................................................................... 16
9 Address ................................................................................................................................................ 16
10 City, State, Zip .................................................................................................................................... 16
11 Home Phone ........................................................................................................................................ 16
12 Message Phone .................................................................................................................................... 16
13 E-Mail Address ................................................................................................................................... 16
14 Citizenship and Alien Document Number .............................................................................................. 16
15 Gender ................................................................................................................................................ 17
16 Race / Ethnicity ................................................................................................................................... 17
17 Highest Grade Completed ..................................................................................................................... 18
18 Highest Degree Attained ...................................................................................................................... 18
19 English Language Difficulty ................................................................................................................. 18
20 Disabled.............................................................................................................................................. 18
21 Currently Working ............................................................................................................................... 18
22 How Many Hours Working................................................................................................................... 18
23 Primary Reason for Being Here............................................................................................................. 19
24 Are You A Veteran .............................................................................................................................. 19
25 Is Spouse in the Military ....................................................................................................................... 19
26 Are You a Migrant or a Seasonal Farm Worker ...................................................................................... 19
27 Is Your Current Situation Due to Special Circumstances ......................................................................... 19
28 How Did You Hear About Us ............................................................................................................... 19
29 Agency Name ...................................................................................................................................... 19
30 Contract Code ..................................................................................................................................... 19
31 Change Log ......................................................................................................................................... 19
Chapter 2 -------------------------------------------------------------------------------------------------------------- 20
WIA Application -------------------------------------------------------------------------------------------------------------- 20
2 Application Date ................................................................................................................................... 26
3 Last Name ............................................................................................................................................ 26
4 First Name ............................................................................................................................................ 26
5 Middle Name ........................................................................................................................................ 26
6 Social Security Number ......................................................................................................................... 26
7 Address ................................................................................................................................................ 26
8 City, State, Zip ...................................................................................................................................... 26
9 Mail Address ......................................................................................................................................... 26
10 Mail City, State, Zip ............................................................................................................................. 26
11 Home Phone ........................................................................................................................................ 26
12 Message Phone .................................................................................................................................... 26
13 E-mail Address .................................................................................................................................... 26
14 GEO Code .......................................................................................................................................... 26
15 Citizenship .......................................................................................................................................... 26
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16 Eligibility to Work in the US ................................................................................................................ 27
17 Gender ................................................................................................................................................ 27
18 Birth Date ........................................................................................................................................... 27
19 Age .................................................................................................................................................... 27
20 Selective Service Registration ............................................................................................................... 27
21 Assessed ............................................................................................................................................. 27
22 Race / Ethnicity .................................................................................................................................. 28
23 Concurrent Participation ....................................................................................................................... 29
24 Disabled.............................................................................................................................................. 30
25 Limited English ................................................................................................................................... 30
26 Substance Abuse .................................................................................................................................. 30
27 Basic Literacy Skills Deficient .............................................................................................................. 30
28 Offender ............................................................................................................................................. 31
29 Pregnant / Parenting Youth ................................................................................................................... 31
30 Youth Needing Additional Assistance ................................................................................................... 31
31 At Risk of Dropping Out ...................................................................................................................... 31
32 Family History of Chronic Unemployment ............................................................................................ 31
33 Gang Involved or Affected ................................................................................................................... 32
34 Immigrant or Refugee .......................................................................................................................... 32
35 Reside in areas with high rates of poverty, crime and unemployment ....................................................... 32
36 Substance Abuse Problem or History ..................................................................................................... 33
37 Former Foster Care .............................................................................................................................. 33
38 Parent, Guardian or Sibling is Incarcerated ............................................................................................ 33
39 Is being raised by someone other than biological parents ......................................................................... 33
40 Would be first-generation high school graduate ...................................................................................... 33
41 Runaway Youth ................................................................................................................................... 33
42 Foster Child ........................................................................................................................................ 33
43 Family TANF ...................................................................................................................................... 33
44 Family GA .......................................................................................................................................... 33
45 Family RCA ........................................................................................................................................ 33
46 Family SSI .......................................................................................................................................... 33
47 Family Food Stamps ............................................................................................................................ 34
48 Number in Family ................................................................................................................................ 34
49 Number of Dependents < Age 18 .......................................................................................................... 34
50 Family Status ...................................................................................................................................... 34
51 Family Income Prior Six Months........................................................................................................... 34
52 Low Income ........................................................................................................................................ 34
53 TANF Exhaustee ................................................................................................................................. 35
54 Homeless ............................................................................................................................................ 35
55 Poor Work History ............................................................................................................................... 35
56 Unemployment Insurance ..................................................................................................................... 35
57 Veteran Status ..................................................................................................................................... 35
58 Disabled Veteran ................................................................................................................................. 35
59 Recently Separated Veteran .................................................................................................................. 35
60 Veteran Separation Date ....................................................................................................................... 35
61 Campaign Veteran ............................................................................................................................... 36
62 Spouse of Qualifying Veteran ............................................................................................................... 37
63 Licensed Health Care Professional/ Current Certification ........................................................................ 37
64 Incumbent Worker Verification Letter ................................................................................................... 37
65 Highest Degree Attained ...................................................................................................................... 37
66 Education Status .................................................................................................................................. 37
67 Highest Grade Completed ..................................................................................................................... 38
68 Read Grade ......................................................................................................................................... 38
69 Read Score .......................................................................................................................................... 38
70 Reading Test ....................................................................................................................................... 38
71 Math Grade ......................................................................................................................................... 38
72 Math Score .......................................................................................................................................... 38
73 Math Test ............................................................................................................................................ 39
74 Labor Force Status ............................................................................................................................... 39
75 Weeks Not Employed Last 26 Weeks .................................................................................................... 39
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76 Hourly Wage ....................................................................................................................................... 39
77 Hours per Week ................................................................................................................................... 39
78 Referred by WPRS .............................................................................................................................. 39
79 Dislocated Worker ............................................................................................................................... 39
80 Job Code at Dislocation ........................................................................................................................ 39
81 Dislocation Date .................................................................................................................................. 39
82 Tenure at Employer of Dislocation ........................................................................................................ 40
83 Dislocation Industry Code .................................................................................................................... 40
84 Employer Number / Address ................................................................................................................. 40
85 Employer Phone .................................................................................................................................. 40
86 Part Time Employment ........................................................................................................................ 40
87 Seasonal Employment .......................................................................................................................... 40
88 Temporary Employment ....................................................................................................................... 40
89 Current Hourly Wage ........................................................................................................................... 40
90 Pre Dislocation Hourly Wage ............................................................................................................... 40
91 Health Benefits .................................................................................................................................... 40
92 Non-Custodial Parent ........................................................................................................................... 41
93 Eligibility ............................................................................................................................................ 41
94 Are all Docs Received? ........................................................................................................................ 42
95 Interviewer .......................................................................................................................................... 42
96 Interview Date ..................................................................................................................................... 42
97 Reviewer............................................................................................................................................. 42
98 Review Date ........................................................................................................................................ 43
99 Agency Name ...................................................................................................................................... 43
100 Contract Code.................................................................................................................................... 43
101 Is Form Complete? ............................................................................................................................. 43
102 Change Log ....................................................................................................................................... 43
103 Fill DESN ......................................................................................................................................... 43
Chapter 3 -------------------------------------------------------------------------------------------------------------- 44
Document Verification Form ------------------------------------------------------------------------------------------------ 44
1 Eligibility Item ...................................................................................................................................... 46
2 Verification Source ................................................................................................................................ 46
3 Verify Status ......................................................................................................................................... 46
4 Review Status ....................................................................................................................................... 46
5 Document Location ............................................................................................................................... 46
6 Receive Date ......................................................................................................................................... 46
7 Verified By ........................................................................................................................................... 46
8 Reviewed By......................................................................................................................................... 46
Chapter 4 -------------------------------------------------------------------------------------------------------------- 47
Alternate Contact Form ------------------------------------------------------------------------------------------------------- 47
1 Contact Name ....................................................................................................................................... 48
2 Relation Type ........................................................................................................................................ 48
3 Other Relation Type .............................................................................................................................. 48
4 Address ................................................................................................................................................ 48
5 City, State Zip ....................................................................................................................................... 48
6 Phone ................................................................................................................................................... 48
7 Comments............................................................................................................................................. 48
8 Change Log .......................................................................................................................................... 48
Chapter 5 -------------------------------------------------------------------------------------------------------------- 49
Workshop Form---------------------------------------------------------------------------------------------------------------- 49
1 Case Number ........................................................................................................................................ 50
2 Workshop Information ........................................................................................................................... 50
3 Activity Code ........................................................................................................................................ 50
4 Workshop Completion Status ................................................................................................................. 50
9 Change Log .......................................................................................................................................... 50
Chapter 6 -------------------------------------------------------------------------------------------------------------- 51
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WIA Enrollment / Registration Form --------------------------------------------------------------------------------------- 51
1 Case Number ........................................................................................................................................ 53
3 Education Status .................................................................................................................................... 53
4 Basic Literacy Skills Deficient ................................................................................................................ 53
5 Grant Code ........................................................................................................................................... 53
6 Labor Force Status ................................................................................................................................. 53
7 Enrollment Date .................................................................................................................................... 54
8 Date ITA Established ............................................................................................................................. 54
9 Total Amount of ITA ............................................................................................................................. 54
10 Pell Grant Recipient ............................................................................................................................. 54
11 Pell Grant School Year Award Amount ................................................................................................. 54
12 NWI Program Type ............................................................................................................................. 54
13 Case Manager ...................................................................................................................................... 54
14 Enrolling Agency ................................................................................................................................. 54
15 Contract ID ......................................................................................................................................... 55
16 Change Log ......................................................................................................................................... 55
Chapter 7 -------------------------------------------------------------------------------------------------------------- 56
Services, Activities and Case Notes ----------------------------------------------------------------------------------------- 56
2 Case Number / Select Enrollment............................................................................................................ 60
3 Activity Type ........................................................................................................................................ 60
4 Activity Code ........................................................................................................................................ 60
5 Start Date .............................................................................................................................................. 60
6 Estimated End Date ............................................................................................................................... 60
7 Actual End Date .................................................................................................................................... 60
8 User ..................................................................................................................................................... 60
9 Completion Code ................................................................................................................................... 60
10 Case Notes .......................................................................................................................................... 60
11 Detail.................................................................................................................................................. 60
Detail Screen Fields – Training Activity Type ............................................................................................ 61
12 Training Type ...................................................................................................................................... 61
13 Provider Code ..................................................................................................................................... 61
14 Program Code ..................................................................................................................................... 61
15 Job Code/Title ..................................................................................................................................... 61
16 ITA Amount Used ............................................................................................................................... 61
17 Employer Number/ Name ..................................................................................................................... 61
18 OJT Wage Subsidy .............................................................................................................................. 61
Detail Screen Fields – Youth Work Experience Activities ............................................................................ 61
19 Employer Number/ Name (Youth) ........................................................................................................ 61
20 Wage .................................................................................................................................................. 62
21 Hours Per Week................................................................................................................................... 62
22 Employment Type ............................................................................................................................... 62
23 Job Code/Title ..................................................................................................................................... 62
Detail Screen Fields – Supportive Service Activities ................................................................................... 62
24 Supportive Services Type ..................................................................................................................... 62
25 Program Cost ...................................................................................................................................... 62
26 Actual Cost ......................................................................................................................................... 62
Activity Codes and Definitions .................................................................................................................. 63
Core A Activity Codes .............................................................................................................................. 63
Core B Activity Codes .............................................................................................................................. 64
Code 100 = Follow-up Services, Counseling............................................................................................... 64
Code 102 = Waive Required Core B Services ............................................................................................ 64
Code 110 = Staff Assisted Job Development............................................................................................... 64
Code 120 = Staff Assisted Job Referrals ..................................................................................................... 64
Code 130 = Staff Assisted Job Search, Placement ....................................................................................... 64
Code 140 = Staff Assisted Workshops/ Job Clubs ....................................................................................... 65
Code 150 = Other Core Services ................................................................................................................ 65
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Code 160 = Non-WIA Funded Core Services.............................................................................................. 65
Code 18 = Local Office Orientation/ IAW .................................................................................................. 65
Code 19 = Job Fair Information ................................................................................................................. 65
Code 21 = Staff Assisted Initial Assessment .............................................................................................. 65
Intensive Activity Codes ........................................................................................................................... 66
Code 245 = Waived Required Intensive Services ........................................................................................ 66
Code 300 = Case Management for Participants ........................................................................................... 66
Code 310 = Comprehensive Assessments ................................................................................................... 66
Code 320 = Development of Individual Employment Plan ........................................................................... 66
Code 330 = Group Counseling .................................................................................................................. 66
Code 340 = Work/Entry Employment Experience ....................................................................................... 66
Code 350 = Individual Counseling and Career Planning .............................................................................. 67
Code 360 = Out-of-Area Job Search........................................................................................................... 67
Code 370 = Relocation Expenses ............................................................................................................... 67
Code 380 = Short Term Pre-vocational Services ......................................................................................... 67
Code 390 = Internships ............................................................................................................................. 67
Code 40 = Other Intensive Services ........................................................................................................... 67
Code 41 = Non-WIA funded Intensive Services .......................................................................................... 67
Code 43 = Order Search (Vet) ................................................................................................................... 67
Code 44 = Bonding Assistance ................................................................................................................. 67
Code 45 = WOTC Eligible (conditional certification) ................................................................................. 67
Training Codes......................................................................................................................................... 68
Code 50 = Adult Education ....................................................................................................................... 68
Code 51 = Customized Training ................................................................................................................ 68
Code 52 = Entrepreneurial Training ........................................................................................................... 68
Code 53 = Job Readiness Training ............................................................................................................. 68
Code 54 = Occupational Skills Training ..................................................................................................... 68
Code 55 = On-the-Job Training ................................................................................................................. 68
Code 56 = Private Sector Training ............................................................................................................. 68
Code 57 = Skill Upgrading and Retraining ................................................................................................. 68
Code 58 = Workplace Training /Cooperative Education .............................................................................. 69
Code 59 = Other Training Services ............................................................................................................ 69
Code 60 = Non-WIA Funded Training Services .......................................................................................... 69
Code 62 = Remedial Training ................................................................................................................... 69
Code 63 = Institution of Higher Education Training .................................................................................... 69
Veterans Program Activity Codes .............................................................................................................. 69
64 = Vet Only – Disabled Veterans’ Outreach Program (DVOP) .................................................................. 69
65 = Vet Only – Local Veteran’s Employment Representative (LVER) ....................................................... 69
600=Vet Only – Literacy/Bilingual Training............................................................................................... 69
601=Vet Only – Institutionalized Skills Training ........................................................................................ 69
602=Vet Only – Apprenticeship Training ................................................................................................... 70
604=Vet Only – Tools/Fees ....................................................................................................................... 70
Youth Activity Codes ............................................................................................................................... 70
700=Summer Work Experience ................................................................................................................. 70
710=Alternative Secondary School ............................................................................................................ 70
711=Tutoring ........................................................................................................................................... 70
712=Preparation for Postsecondary Education ............................................................................................ 70
713=Postsecondary Education ................................................................................................................... 71
714=Basic Skills ...................................................................................................................................... 71
715 =GED Preparation.............................................................................................................................. 71
716=Incentives ......................................................................................................................................... 71
720=Occupational Skills/Advanced Training .............................................................................................. 71
721=Work Experience .............................................................................................................................. 71
722=Work Readiness ................................................................................................................................ 71
723=Job Placement Services ..................................................................................................................... 71
724=Job Shadow ...................................................................................................................................... 71
725= Preparation for Occupational or Vocational Education/ Training .......................................................... 72
726 = Occupational Skill Attainment ......................................................................................................... 72
727 = Work Readiness Skill Attainment ..................................................................................................... 72
728 =WAY Internship .............................................................................................................................. 72
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730=Leadership Development ................................................................................................................... 72
731=Mentoring by Peers ........................................................................................................................... 72
732=Community Service .......................................................................................................................... 72
740=Assessment ...................................................................................................................................... 72
741=Mentoring by Adults ......................................................................................................................... 73
742=Comprehensive Substance Abuse and/or Psychological Counseling ...................................................... 73
743=High School Certificate of Completion ............................................................................................... 73
744=Computer Literacy Skills ................................................................................................................... 73
745=Life Skills Activities ......................................................................................................................... 73
746=Development of the ISS ..................................................................................................................... 73
747=Case Management Services ............................................................................................................... 73
748=High School Diploma Attainment ...................................................................................................... 73
749=GED Attainment ............................................................................................................................... 73
750=Other Degree or Certificate Attainment............................................................................................... 73
751=Financial Literacy ............................................................................................................................. 74
753=Return to Secondary School ............................................................................................................... 74
754=Grade Level Advancement ................................................................................................................ 74
755=GPA Increase ................................................................................................................................... 74
756=Satisfactory School Attendance .......................................................................................................... 74
757=Justice System Aversion (6 months) ................................................................................................... 74
760=Supportive Services .......................................................................................................................... 74
770=Pre-Exit Follow Up Services .............................................................................................................. 75
Post Exit Youth Codes (800 Series) ........................................................................................................... 75
Miscellaneous Activity Codes ................................................................................................................... 75
Code 80 = Other JTPA.............................................................................................................................. 75
Code 81 = Supportive Services .................................................................................................................. 75
Code 82 = Needs-Related Payments ........................................................................................................... 75
Code 83 = Planned Break in Service: Delay in Training............................................................................... 75
Code 84 = Non-WIA Funded Miscellaneous ............................................................................................... 76
Code 86 = Planned Break in Service: Health/Medical .................................................................................. 76
Code 93 = Referral to Supportive Services Provider .................................................................................... 76
Code 94 = Referral to Other Agency .......................................................................................................... 76
Code 95 = Non-WIA Funded Supportive Services....................................................................................... 76
Chapter 8 -------------------------------------------------------------------------------------------------------------- 77
IEP Form------------------------------------------------------------------------------------------------------------------------ 77
Background Information ........................................................................................................................... 82
1 Date ..................................................................................................................................................... 82
2 Agency ................................................................................................................................................. 82
3 High School Diploma ............................................................................................................................ 82
4 Any Additional Education or Vocational Training .................................................................................... 82
5 What Areas ........................................................................................................................................... 82
6 Any Additional Diplomas/ Degree/ Certifications ..................................................................................... 82
7 Diplomas/ Degrees/ Licenses .................................................................................................................. 82
8 Additional Education/ Vocational Training taken ..................................................................................... 82
Employment History................................................................................................................................. 83
9 Internal Job Title ................................................................................................................................... 83
10 From Date/ To Date ............................................................................................................................. 83
11 Job Duties ........................................................................................................................................... 83
12 Reason for Leaving .............................................................................................................................. 83
Barriers ................................................................................................................................................... 83
13 Barrier Type ........................................................................................................................................ 83
14 User.................................................................................................................................................... 83
15 Barrier Code........................................................................................................................................ 83
16 Barrier Name ....................................................................................................................................... 83
17 Open date ............................................................................................................................................ 83
18 Notes .................................................................................................................................................. 83
Assessment Results .................................................................................................................................. 83
19 Reading Test/Score .............................................................................................................................. 83
20 Reading Test Date................................................................................................................................ 83
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21 Math Test/Score .................................................................................................................................. 83
22 Math Test Date .................................................................................................................................... 83
23 Other Proficiency Test/Score and Date .................................................................................................. 84
24 Interest Assessment Method ................................................................................................................. 84
25 Interest Inventory Test ......................................................................................................................... 84
26 Interest Inventory Test Date .................................................................................................................. 84
27 Interest Inventory Test Results/ Comments ............................................................................................ 84
28 Aptitude Inventory Test ........................................................................................................................ 84
29 Aptitude Inventory Test Date ................................................................................................................ 84
30 Aptitude Inventory Test Results/ Comments .......................................................................................... 84
31 Transferable Skills Test ........................................................................................................................ 84
32 Transferable Skills Test Date ................................................................................................................ 84
33 Transferable Skills Test Results/ Comments ........................................................................................... 84
34 Additional Test .................................................................................................................................... 84
35 Additional Test Date ............................................................................................................................ 84
36 Additional Test Results/Comments........................................................................................................ 84
Assessment Summary ............................................................................................................................... 84
37 Assessment Date .................................................................................................................................. 84
38 Summary ............................................................................................................................................ 85
39 Assets and Obstacles ............................................................................................................................ 85
40 Recommendations................................................................................................................................ 85
41 Services to Consider ............................................................................................................................ 85
42 Counselor............................................................................................................................................ 85
43 Assessment Site ................................................................................................................................... 85
Set Goals ................................................................................................................................................. 85
44 Occupational/ Job Code........................................................................................................................ 85
45 Industry Code ...................................................................................................................................... 85
46 Job Ready Status.................................................................................................................................. 85
47 Notes .................................................................................................................................................. 85
Chapter 9 -------------------------------------------------------------------------------------------------------------- 86
WIA Youth Test Scores Form ----------------------------------------------------------------------------------------------- 86
Introduction and Form Purpose.................................................................................................................. 86
1 ESL ...................................................................................................................................................... 89
2 Test Type .............................................................................................................................................. 89
3 Functional Area ..................................................................................................................................... 89
4 Test Score ............................................................................................................................................. 90
5 Education Level .................................................................................................................................... 90
6 Date Administered ................................................................................................................................. 90
Chapter 10 ------------------------------------------------------------------------------------------------------------ 91
Referral Form ------------------------------------------------------------------------------------------------------------------ 91
1 Case Number ........................................................................................................................................ 92
2 Activity Type ........................................................................................................................................ 92
3 Activity Code ........................................................................................................................................ 92
4 Referral From........................................................................................................................................ 92
5 Referral To ........................................................................................................................................... 92
6 Purpose................................................................................................................................................. 92
7 Referral Date ......................................................................................................................................... 92
8 Referred By .......................................................................................................................................... 92
9 Follow-up Date ..................................................................................................................................... 92
10 Follow-up By ...................................................................................................................................... 92
11 Referral Result .................................................................................................................................... 92
12 Change Log ......................................................................................................................................... 92
Screen Shot(s) of WIA Placement Form ------------------------------------------------------------------------------- 92
Chapter 11 ------------------------------------------------------------------------------------------------------------ 93
WIA Placement Form --------------------------------------------------------------------------------------------------------- 93
1 Employment Date .................................................................................................................................. 94
2 Employer Name .................................................................................................................................... 94
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3 Contact Person ...................................................................................................................................... 94
4 Contact Phone ....................................................................................................................................... 94
5 Job Code/Title ....................................................................................................................................... 94
6 Industry Code/Title ................................................................................................................................ 94
7 Hours Per Week .................................................................................................................................... 94
8 Hourly Wage ......................................................................................................................................... 94
9 Training Related Employment ................................................................................................................ 94
10 Determination Method ......................................................................................................................... 95
11 Health Benefits .................................................................................................................................... 95
12 Non-Traditional Employment ............................................................................................................... 95
13 Non-Covered Employment ................................................................................................................... 95
13 Change Log ......................................................................................................................................... 95
Chapter 12 ------------------------------------------------------------------------------------------------------------ 96
Exit Form ----------------------------------------------------------------------------------------------------------------------- 96
2 Education Status .................................................................................................................................... 99
3 Exit Code .............................................................................................................................................. 99
1 = Entered Employment .......................................................................................................................... 99
2 = Called Back/Remained with Layoff Employer....................................................................................... 99
3 = Entered Advanced Training ............................................................................................................... 100
4 = Entered Post Secondary Education ..................................................................................................... 100
5 = Attained Recognized Certificate/Diploma/Degree ............................................................................... 100
6 = Planned Services Completed .............................................................................................................. 100
7 = Planned Services Not Completed ....................................................................................................... 100
8 = Lacks Transportation ........................................................................................................................ 100
9 = Family Care ..................................................................................................................................... 101
10 = Health/Medical ............................................................................................................................... 101
11 = Cannot Locate ................................................................................................................................ 101
12 = Death ............................................................................................................................................. 101
13 = Institutionalized .............................................................................................................................. 101
14 = Voluntary Other .............................................................................................................................. 101
15 = Objective Assessment Only ............................................................................................................. 102
16 = Returned to Secondary Education (Youth Only) ................................................................................ 102
17 = Soft Exit......................................................................................................................................... 102
18 = Reservists Recalled ......................................................................................................................... 102
19 = Mandated Residential Program (Youth Only) .................................................................................... 102
4 Placement Detail ................................................................................................................................. 102
5 Exit Date ............................................................................................................................................ 102
6 Soft Exit Determination Date ................................................................................................................ 102
7 Degree Attained .................................................................................................................................. 103
8 Type of Degree Attained ...................................................................................................................... 103
9 Date Degree or Certificate Attained....................................................................................................... 103
10 Entered Post Secondary Education ...................................................................................................... 103
11 Entered Advanced Training ................................................................................................................ 103
12 Entered Military Service ..................................................................................................................... 103
13 Entered Qualified Apprenticeship........................................................................................................ 104
14 Exit Staff .......................................................................................................................................... 104
15 Exit Notes ......................................................................................................................................... 104
16 Agency Name .................................................................................................................................... 104
17 Contract Name .................................................................................................................................. 104
18 Change Log ....................................................................................................................................... 104
Chapter 13 -----------------------------------------------------------------------------------------------------------105
Follow-Up Form -------------------------------------------------------------------------------------------------------------- 105
Introduction and Form Purpose................................................................................................................ 105
1 Follow-Up Type (After Exit) ................................................................................................................ 110
2 Follow-Up Due Date ............................................................................................................................ 110
3 Interview Date ..................................................................................................................................... 110
4 Follow-up Result ................................................................................................................................. 110
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5 Labor Force Status ............................................................................................................................... 110
6 Supplemental Data Verified Employment Status First Quarter after Exit .................................................. 110
7 Supplemental Data Verified Employment Status Second Quarter after Exit .............................................. 110
8 Supplemental Data Verified Employment Status Third Quarter after Exit ................................................. 111
10 Type of Degree Attained .................................................................................................................... 111
11 Continuing In Post Secondary Education ............................................................................................. 111
12 Continuing In Advanced Training ....................................................................................................... 111
13 In Military Service ............................................................................................................................. 111
14 In Qualified Apprenticeship ................................................................................................................ 112
15 Weeks Employed ............................................................................................................................... 112
16 With Exit Employer ........................................................................................................................... 112
17 Actual Hours Worked ........................................................................................................................ 112
18 Date Employed .................................................................................................................................. 112
19 Employer Number ............................................................................................................................. 112
20 Contact Person .................................................................................................................................. 112
21 Contact Phone ................................................................................................................................... 112
22 Job Code/Title ................................................................................................................................... 112
23 Industry Code/Title ............................................................................................................................ 112
24 Hours Per Week................................................................................................................................. 112
25 Hourly Wage ..................................................................................................................................... 112
26 Follow-up Staff ID ............................................................................................................................. 113
27 Agency Name .................................................................................................................................... 113
28 Contract ............................................................................................................................................ 113
29 Change Log ....................................................................................................................................... 113
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Introduction
The Customer Information Services Reporting System (CISRS) Workforce Investment Act
(WIA) Forms and Procedures Handbook has been developed to clarify the procedures for
recording customer data and services in CISRS for customers receiving WIA services. The
intent is to increase the consistency of the use of CISRS and therefore the consistency of the
data and the accuracy of data reporting. The resulting standardization and proper use of the
activity codes will also aid case managers and other staff in tracking a client’s history,
progression, and status, and will enhance the Career Center or Service Provider’s ability to
provide seamless and comprehensive services.
This Handbook provides line item instructions for completing the WIA Forms in CISRS.
The instructions are not intended to provide instruction on data entry and navigation steps for
using CISRS. For these instructions, please refer to the CISRS Training User Guide that is
distributed at CISRS navigational training or upon request through a Program Specialist.
Many of the procedures covered in this handbook are basic daily functions and are provided
for new staff just learning the job. However, the handbook should serve as a reference
manual for even the most experienced staff.
The chapters of this Handbook are organized to cover each of the WIA Forms in CISRS.
The WIA forms that will be covered in this Handbook are listed below.
1. SDWP Membership Application;
2. WIA Application;
3. Documents Verification;
4. Workshops;
5. Alternate Contact Information;
6. WIA Enrollment /Registration;
7. Service Record, Activities and Case Notes;
8. Individual Employment Plan (IEP);
9. WIA Test Scores Form;
10. Referral Services;
11. Placement;
12. Exit; and
13. WIA Follow-Up.
The procedures and definitions outlined in this Handbook are intended to support the service
flow protocols established by the existing policies and procedures. As such, Adult &
Dislocated Worker clients identified to move beyond Core A self-services, to receive WIAfunded staff-assisted services, must be registered/enrolled in WIA. Once a client has been
determined eligible for WIA and has been enrolled, the client must follow a standard flow of
services from Core B services to Intensive services, and then, if appropriate, to Training
services. Consequently, a client must be enrolled in:
• First, at least one Core B Activity, such as Staff-Assisted Job Search/Placement;
• Followed by at least one Intensive Activity.
If determined necessary, the client might then be enrolled in,
• A Training Activity (there are additional requirements for an ITA).
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Services are provided by staff which empower individual clients to determine and reach their
employment goals. Activities added to a client’s Service Record in CISRS must reflect the
actual services defined in this handbook. Therefore, in addition to adding an activity to a
client’s Service Record, the service must be accompanied by a case note in CISRS. It
may also require other documentation in the client’s hard copy case file. Conversely, a
case note may be necessary even if a service has not been provided, such as in the case of an
unsuccessful attempt to contact a client, or the client declining a service offered.
Each chapter of this Handbook includes three important sections. First, a summary of the
information the form is intended to collect, and why it is important. Secondly, is a “screen
shot” which graphically illustrates the form, with each of the fields numbered for
identification.
The final section of each chapter is a table of definitions for each field and activity code. The
left column identifies the name of the field and the field number from the screen shot. Fields
which require input in order for the form to be saved in CISRS, are marked with the
symbol “ ”, as they do in CISRS. The right column includes a locally applicable
definition of the field.
All questions surrounding the interpretation and proper use of this handbook should be
directed to your San Diego Workforce Partnership Program Specialist. CISRS Data Systems
support staff should only be contacted regarding the technical operational and system training
aspects of the CISRS application. For technical problems, use the HEAT Self System (HSS)
available at http://helpdesk.workforce.org.
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Chapter 1
Membership Application Form
Introduction and Purpose
The Membership Form is the first step in the process of receiving WIA services. All
customers receiving services, including youth, must complete this form.
The Membership Form is used to record a customer’s first visit to a WIA funded program. It
is necessary to complete this form in CISRS before beginning a WIA Application. The
Membership Form also captures pertinent demographic information, which aids in local
workforce development projects or initiatives. All information is self-disclosed; no proof of
any documentation or eligibility is required at this point for a customer to access Core A
services. After the mandatory information is recorded and saved, an application number is
generated.
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1 Application Number
The Application Number will automatically be assigned by the system.
2 Membership Date
Enter the membership application date. The system will default to the current date, but may be edited to a past
date.
3 Last Name
Enter the client's last name.
4 First Name
Enter the client's first name.
5 Middle Name
Enter the client's middle name.
6 Social Security Number
7 Birth Date
8 Age
Enter the client’s nine-digit social security number. A pseudo social security number may be used, however a
valid social security number must be used if the participant fills out a WIA Application and is enrolled. If
a pseudo social security number is used, it should be in the format of the first three letters of the participant’s last
name, the month the participant was born, and the year of birth. Mary Smith, born on March 6, 1965 would have
a pseudo social security number of SMI-03-1965.
Enter the client’s birth date. Once the birth date is entered, the age of the client will automatically be calculated
by the system.
Once the birth date is entered, the age of the client will automatically be calculated by the system.
9 Address
Enter the client's home street address, including apartment numbers and/or letters. Post office box and/or RFD
numbers are acceptable for homeless individuals and for those who live in rural areas.
10 City, State, Zip
Using the Search method (clicking on the Search link) will populate the city, state, and zip code fields for the
client’s home city, state, and zip code.
11 Home Phone
12 Message Phone
13 E-Mail Address
Enter the client’s home phone number, including the area code. Enter the numbers only; the system will add
parentheses and dashes. If the client does not have a home phone number, record a phone number in Message
Phone, where the client can receive messages, or record a number here where the client may be reached. Alternate
phone numbers such as cell phones, pagers, or faxes may be entered in the Alternate Contact Form.
Enter a phone number including the area code, where the client can receive messages. This number should be
different from the home phone number.
Enter the client’s Email address, if any (e.g. [email protected]).
The client must be a U.S. citizen or an eligible non-citizen to receive WIA-funded services.
Choose from the following:
14 Citizenship and Alien
Document Number
U.S. Citizen—A person entitled by birth or naturalization to the protection of a given state of the United States
and authorized by the Attorney General to work in the United States.
Eligible Non-Citizen—Eligible non-citizens are either: nationals, lawfully admitted permanent resident aliens,
refugees, asylees, parolees, or other immigrants authorized by the Attorney General to work in the United States.
If this is chosen, enter the document number of the alien registration card that establishes the client’s
eligibility. (Please refer to I-9 Form list of Acceptable Documentation.)
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May 2010
Ineligible Non-Citizen—An individual who is neither a citizen nor an eligible non-citizen that is authorized to
work in the United States. The individual is ineligible for the WIA program.
This information must be verified upon registration into WIA.
15 Gender
Enter the gender of the client.
The following list includes brief guidelines for the inclusion into a specific racial or ethnic group. A participant
may select up to 6 categories.
Asian Indian
Persons who indicate their race as Asian Indian, as well as persons who did not classify themselves in one of the
specific race categories, but reported entries such as Bengali, Bharati, Dravidian, East Indian, Goanese, Hindu
India, Kashmiri, or South Asian.
Cambodian
Persons who indicate their race as Cambodian. Cambodia is a former name for the Khmer Republic.
Chinese
Persons who indicate their race as Chinese, as well as persons who did not classify themselves in one of the
specific race categories, but reported entries such as Cantonese, Formosan, Taiwanese, or Tibetan.
Filipino
Persons who indicate their race as Filipino, as well as persons who did not classify themselves in one of the
specific race categories, but reported entries such as Filipino American or Philippine.
Guamanian
Persons who indicate their race as Guamanian, as well as persons, who did not classify themselves in one of the
specific race categories, but reported entries such as Chamorro or Guam.
Hawaiian
Persons who indicated their race as Hawaiian native, i.e., an individual whose ancestors were natives, prior to
1778, of the area which now comprises the state of Hawaii.
16 Race / Ethnicity
Japanese
Persons who indicated their race as Japanese, as well as persons who did not classify themselves in one of the
specific race categories, but reported entries such as Nipponese or Japanese American.
Korean
Persons who indicated their race as Korean or Korean American.
Laotian
Persons who indicated their race as Laotian.
Samoan
Persons who indicated their race as Samoan, American Samoan or Western Samoan.
Vietnamese
Persons who indicated their race as Vietnamese.
Other Pacific Islanders
Persons who indicated their race as Pacific Islander with categories other than the eleven categories listed above,
e.g. Maoris, Fiji Islander, Tahitian or Thai.
Other Asian
A person who indicated their race as Asian other than the categories listed above, e.g., Hmong, Indo-Chinese, or
Pakistani.
Black-African American
A person having origins in any of the black racial groups of Africa.
Hispanic or Latino
A person of Mexican, Puerto Rican, Cuban, Central, or South American, or other Spanish culture or origin
(including Spain), regardless of race. Among persons from Central and South American countries, only those who
17
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are of Spanish origin, descent, or culture should be included in this category. Persons from Brazil, Guiana, and
Trinidad, for example, would be classified according to their race, and would not necessarily be included in this
category. Also, the Portuguese should be excluded from this category and should be classified by their race.
Note: Federal guidance requires ethnicity information to be collected separately from race information. If
the Hispanic or Latino ethnicity is selected, a client’s race should also be identified.
American Indian/Alaskan Native
A person having origins in any of the original peoples of North America, and who maintain cultural identification
through tribal affiliation or community recognition.
White
A person having origins in any of the original people of Europe, North Africa, or the Middle East.
Enter the highest grade number that applies to the client.
Enter 00 if the client did not complete any school grades.
01-11 Enter the number of elementary/secondary school grades completed. Individuals who completed 12th grade
but did not receive a diploma or equivalent are to be coded 11. Disabled participants who received a Certificate
of Completion or an IEP diploma are to be coded as 11.
17 Highest Grade
Completed
12 High School graduate or equivalent.
88 Attained certificate of equivalency for a high school degree.
13-15 If a high school graduate, the number of school years completed including college or full-time technical or
vocational school.
16 Bachelor’s degree or equivalent.
17 Five years or more of college, a Master’s degree, Ph.D. or equivalent.
Select the highest degree that the client has attained, or their school status:
18 Highest Degree
Attained
19 English Language
Difficulty
20 Disabled
•
•
•
•
•
•
•
Student, High School or less
High School Dropout
High School Diploma
GED or Equivalent
Associates Degree
Bachelors Degree
Masters or Doctorate Degree
Choose Yes if the client’s native language is not English, and has a limited ability to communicate in English,
resulting in a barrier to employment.
If the above condition is not met please choose No.
Choose Yes if the client has a physical or mental impairment, which substantially limits one or more major life
activities and has a record of such impairment, or is regarded as having such impairment, or that constitutes or
results in a substantial impediment to employment.
Choose Yes if the individual is currently employed at the time of the Application.
21 Currently Working
22 How Many Hours
Enter the number of hours per week the participant is working, or is scheduled to work.
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Working
If more than one reason is stated, select the reason that best fits.
23 Primary Reason for
Being Here
If Other Reason is selected please enter the reason that the individual came to the Center if that reason did not
appear among the selections in the list in the previous field. If a reason was selected from the previous list, this
field should be left blank.
Choose Yes if the client served in the active US military, navy, army, coast guard, marines or air service and was
discharged or released from such service under conditions other than dishonorable.
24 Are You A Veteran
Choose Yes is the client’s spouse is currently serving in the armed services.
25 Is Spouse in the
Military
Choose Yes if the individual has been working as a migrant or seasonal farm worker.
26 Are You a Migrant or a
Seasonal Farm Worker
27 Is Your Current
Situation Due to Special
Circumstances
28 How Did You Hear
About Us
If the client’s current employment circumstance is due to one of the listed special circumstances, select the
circumstance that is most relevant. Leave blank if not applicable.
Please indicate how the individual heard about our services. If more than one referral source is stated, choose the
referral that best fits. If none of the referral sources apply, choose Other and enter the referral source in the text
box next to the Other button.
29 Agency Name
The system defaults this field to the Agency Name selected by the user at Log In or subsequently on the Home
Page. The user should check to make sure the agency name reflects the name of the appropriate agency.
30 Contract Code
Select the contract code of the current contract. If the contract code was previously selected by the user on the
Home Page, this field will default to that contract number. The user should check to make sure the contract
number reflects the name of the appropriate contract.
31 Change Log
The system records the date and the name of the logged in system user that entered this original record. Then the
system records the date, time, and name of the user who last edited this particular record.
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May 2010
Chapter 2
WIA Application
The WIA Application is used primarily to record information necessary to calculate
eligibility for WIA funded programs. The information is also important for capturing the
characteristics and barrier information that can be used to describe the populations served by
WIA programs, or by a particular center or provider. Some fields on the WIA Application
are automatically populated from the Membership Form.
Information recorded on the WIA Application for eligibility determination must be verified
based on locally defined WIA eligibility requirements. Eligibility Specialists need to refer to
the most recent Operations Issuance for the particular eligibility requirements for their
programs. Hard copies of the eligibility documents shall be kept in the client’s file. WIA
eligibility requirements are not addressed in this Handbook. For detailed WIA eligibility
requirements and information refer to the San Diego Workforce Partnership's Operations
Manual, Chapter VII, WIA Eligibility Certification Process.
In addition to recording any demographic information or barrier to employment required for
eligibility purposes, the San Diego Workforce Partnership (Workforce Partnership) requires
that all known barriers be recorded. Documentation will continue to be required only for
those barriers used for WIA eligibility purposes. However by recording all demographic
information and employment barriers, the Workforce Partnership and service providers will
have a more comprehensive description of the participants in the programs.
Note: The client is not registered until a WIA Enrollment / Registration Form is completed.
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May 2010
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May 2010
The application number is assigned automatically by the system.
2 Application Date
Enter the WIA application date. This is the date the client's eligibility is determined for the program. This field
defaults to the current date, but may be edited to a previous date.
3 Last Name
Enter the client's last name.
4 First Name
Enter the client’s first name.
5 Middle Name
Enter the client's middle name.
6 Social Security
Number
Enter the client’s social security number in 123-45-6789 format. If the client was assigned a pseudo social
security number for the Membership Application, this field MUST be updated to reflect their true SSN.
7 Address
Enter the client's home street address, including apartment numbers and/or letters. Post office box and/or RFD
numbers are acceptable for homeless individuals and for those who live in rural areas.
8 City, State, Zip
Using the select method (pressing the select button) will pre-populate the city, state and zip code fields for the
client’s home city, state and zip code.
9 Mail Address
Enter the client’s mailing address if different from the home address.
10 Mail City, State, Zip
Using the select method (pressing the select button) will pre-populate the city, state, and zip code fields for the
client’s mail city, state, and zip code.
11 Home Phone
Enter the client’s home phone number, including the area code. Enter the numbers only; the system will add
parentheses and dashes. If the client does not have a home phone number, record a phone number in Message
Phone. Alternate phone numbers such as cell phones or pagers may be entered in the Alternate Contacts Form.
The Home Phone may be used in customer satisfaction survey research, case management services, and during
follow-up once the client has exited the program.
12 Message Phone
Enter a phone number including the area code, where the client can receive messages. Enter the numbers only; the
system will add parentheses and dashes. This number should be different from the home phone number. The
Message Phone may be used in customer satisfaction survey research, and during follow-up once the client has
exited the program.
13 E-mail Address
Enter the client’s Email address, if any (e.g. [email protected]).
14 GEO Code
Enter the appropriate geographic code. A link to the GEO Codes is available from within the system. Once
you've entered an appropriate address you can click on the GEO Code button which will take you to the Census
tract web site. When the site opens locate the line that says Census Tract: Census Tract. GEO code (Census tract
number) will follow. Go back to the GEO Code field, and enter the appropriate geographic code.
15 Citizenship
The client must be a U.S. citizen or an eligible non-citizen to receive WIA-funded services. If the client’s
citizenship status was entered in the Membership Application it MUST be validated and confirmed in the WIA
Application. Choose from the following:
U.S. Citizen—A person entitled by birth or naturalization to the protection of a given state of the United States
and authorized by the Attorney General to work in the United States.
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May 2010
Eligible Non-Citizen—Eligible non-citizens are either: nationals, lawfully admitted permanent resident aliens,
refugees, asylees, parolees, or other immigrants authorized by the Attorney General to work in the United States.
If this is chosen, enter the document number of the alien registration document that establishes the client’s
eligibility. (Please refer to I-9 Form list of Acceptable Documentation.)
Ineligible Non-Citizen—An individual who is neither a citizen nor an eligible non-citizen that is authorized to
work in the United States. The individual is ineligible for the WIA program.
16 Eligibility to Work in
the US
Select whether the Client in eligible to work in the U.S.
17 Gender
Enter the gender of the client.
18 Birth Date
If the client’s birth date was entered in the Membership Application it MUST be validated and confirmed in the
WIA Application. Enter the client’s birth date.
19 Age
Once the birth date is entered, the age of the client will automatically be calculated by the system.
20 Selective Service
Registration
Yes, Registered—The client has registered in accordance with the Military Selective Service Act (Title 50 USC
Appendix, Section 453).
No, Not Registered—The client has not registered in accordance with the Military Selective Service Act. This
individual is not eligible for WIA.
Exempt—This list includes:
(a) Military Officer Procurement Program students at the Citadel, North Georgia College, Norwich University,
and the Virginia Military Institute;
(b) Men who are hospitalized, incarcerated, or institutionalized (must register within 30 days of release);
(c) Lawful non-immigrants on visas; and
(d) Men who entered the United States after attaining their 26th birthday.
Not Required—The Selective Service registration requirement does not apply to:
(a) Females;
(b) Males born prior to January 1,1960, or
(c) Males who have not yet reached their 18th birthday;
(d) Cadets and midshipmen at the service academies; and
(e) Men on active duty in the Armed Forces.
Male youth who turn 18 while enrolled must be referred to Selective Service registration in order to continue
receiving WIA Youth Services. For WIA Selective Service Registration requirements refer to Workforce
Partnership Operations Manual, Chapter VII.
21 Assessed
Yes, WIA - The client was assessed within the last 12 months prior to WIA participation funded by WIA monies.
Yes, Non-WIA - The client was assessed within the last 12 months prior to WIA participation not funded by
WIA.
No -- The client was not assessed.
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May 2010
22 Race / Ethnicity
The following list includes brief guidelines for the inclusion into a specific racial or ethnic group. A participant
may select up to 6 categories.
Asian Indian
Persons who indicate their race as Asian Indian, as well as persons who did not classify themselves in one of the
specific race categories, but reported themselves as Bengali, Bharati, Dravidian, East Indian, Goanese, Hindu
India, Kashmiri, or South Asian.
Cambodian
Persons who indicate their race as Cambodian. Cambodia is a former name for the Khmer Republic.
Chinese
Persons who indicate their race as Chinese, as well as persons who did not classify themselves in one of the
specific race categories, but reported entries such as Cantonese, Formosan, Taiwanese, or Tibetan.
Filipino
Persons who indicate their race as Filipino, as well as persons who did not classify themselves in one of the
specific race categories, but reported entries such as Filipino American or Philippine.
Guamanian
Persons who indicate their race as Guamanian, as well as persons, who did not classify themselves in one of the
specific race categories, but reported entries such as Chamorro or Guam.
Hawaiian
Persons who indicated their race as Hawaiian native, i.e., an individual whose ancestors were natives, prior to
1778, of the area which now comprises the state of Hawaii.
Japanese
Persons who indicated their race as Japanese, as well as persons who did not classify themselves in one of the
specific race categories, but reported entries such as Nipponese or Japanese American.
Korean
Persons who indicated their race as Korean or Korean American.
Laotian
Persons who indicated their race as Laotian.
Samoan
Persons who indicated their race as Samoan, American Samoan or Western Samoan.
Vietnamese
Persons who indicated their race as Vietnamese.
Other Pacific Islanders
Persons who indicated their race as Pacific Islander with categories other than the eleven categories listed above,
e.g. Maoris, Fiji Islander, Tahitian or Thai.
Other Asian
A person who indicated their race as Asian other than the categories listed above, e.g., Hmong, Indo-Chinese, or
Pakistani.
Black-African American
A person having origins in any of the black racial groups of Africa.
Hispanic or Latino
A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin
(including Spain), regardless of race. Among persons from Central and South American countries, only those who
are of Spanish origin, descent, or culture should be included in this category. Persons from Brazil, Guiana, and
Trinidad, for example, would be classified according to their race, and would not necessarily be included in this
category. Also, the Portuguese should be excluded from this category and should be classified by their race.
Note: Federal statutes require ethnicity information to be collected separately from race information. If the
Hispanic or Latino ethnicity is selected, a client’s race should also be identified.
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May 2010
American Indian/Alaskan Native
A person having origins in any of the original peoples of North America, Central America, or South America, and
who maintain cultural identification through tribal affiliation or community recognition.
White
A person having origins in any of the original people of Europe, North Africa, or the Middle East.
23 Concurrent
Participation
Indicate if the applicant is participating in any of the following programs. These items may be updated at anytime
while the individual is receiving WIA services (except follow-up services).
Yes—The client received services from this source, other than informational or self-service only. This activity is
coordinated with the individual’s WIA activities by inclusion in their WIA service plan or through the follow-up
services.
No – The client did not receive any services, other than informational services from each of the listed programs.
Native American Program WIA Title I-Subtitle D, Sec. 166
Veterans’ Workforce Investment Programs Provided training services under WIA Sec. 168.
Veterans’ DVOP/LVER Services provided by DVOP/LVER (WIA Sec.121(b)(1)(IX)).
Trade Adjustment Act Services funded by Trade Adjustment Act.
NAFTA-TAA Services funded by NAFTA-TAA.
Vocational Education Described in the Carl D.Perkins Voc. And Applied Tech. Ed. Act (20 U.S.C. 2471).
Vocational Rehabilitation- WIA Title IV
Wagner-Peyser Services funded by Wagner-Peyser Act.
WtW Participant As described in 20 CFR Part 645.
Title V Activities (OAA) Title V of the Older Americans Act of 1965 (42 U.S.C. 3056 et seq.).
Comm Srvc Blk Grant Pgm 42 U.S.C. 9001 et seq.
HUD Pgm Any employment and training services funded by the Dept. of Housing and Urban Development.
Other non-WIA pgm Any non-WIA program not listed above that provided the individual with services
authorized under WIA. Record only those programs that fund activities coordinated with the individual’s WIA
Title I activities possibly through a formal co-enrollment, by inclusion in the individual’s WIA service plan, or
through follow-up services.
Rapid Response WIA Sec. 134(a)(2)(A)(I) Individual who participated in rapid response activities before WIA
registration.
Rapid Response Additional Assistance An Individual who participated in a program funded by the State under
WIA section 134(a)(2)(A)(ii).
TANF Services
Adult Education-WIA Title II – Adult education, basic skills and/or literacy activities. This service must be
offered in combination with other allowable training services (not including customized training).
Job Corps-WIA Title I-Subtitle C
Farmworker Program-WIA Title I-Subtitle D, Sec. 167
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May 2010
24 Disabled
Yes, Major—The client has a physical or mental impairment, which substantially limits one or more major life
activities and has a record of such impairment, or is regarded as having such impairment.
Yes, Substantial —The client has a physical or mental impairment that constitutes or results in a substantial
impediment to employment.
No – The client does not have a disability.
Disabled: An individual who has a physical (motion, vision, hearing) or mental (learning or developmental)
impairment which substantially limits one or more of such person’s “major life activities” (see below) and has a
record of such an impairment, or is regarded as having such an impairment and the individual’s physical or mental
impairment constitutes or results in a substantial impediment to employment.
Clarification of terms included in the definition of a disability are provided below:
a)
“Major life activities” include seeing, hearing, speaking, walking, breathing, performing manual tasks,
learning, caring for oneself, and working. A person with epilepsy, paralysis, HIV infection, AIDS, a
substantial hearing or visual impairment, mental retardation, or a specific learning disability is covered, but
an individual with a minor, non-chronic condition of short duration, such as a sprain, broken limb, or the flu,
generally would not be covered.
b)
A record of a disability would cover, for example, a person who has recovered from cancer or mental illness.
c)
Protects individuals who are regarded as having a substantially limiting impairment, even though they may
not have such impairment. For example, a person with a severe facial disfigurement may be “regarded as
having an impairment” because an employer fears the "negative reactions" of customers or co-workers.
d)
If an individual is currently engaging in the use of illegal drugs he/she is excluded from the definition of a
qualified individual with a disability – however, if the individual is, or has in the past sought treatment for
illegal drug use or is currently in a treatment program this person could be considered an individual with a
disability.
e)
A person who currently uses alcohol is not automatically denied protection under ADA. An alcoholic is
considered a person with a disability and is protected by the ADA if s/he is qualified to perform the essential
functions of the job or can successfully benefit from the youth program.
This clarification is taken from the U.S. Department of Justice’s web page: www.usdoj.gov/crt/ada “ADA
Questions and Answers.”
25 Limited English
Yes—An individual with a limited ability speaking, reading, writing, or understanding English, resulting in a
barrier to employment, and (a) whose native language is not English, or (b) who lives in a family or community
environment where a language other than English is the dominant language. Also, the inability of an individual,
whose native language is not English, to communicate in English and whose cultural differences, due to
customary beliefs, social norms and material traits, results in a barrier to employment.
No – Does not meet the above definition of Limited English.
26 Substance Abuse
Yes—The client requires substance abuse treatment in order to obtain employment.
No – The client does not require substance abuse treatment in order to obtain employment.
27 Basic Literacy Skills
Deficient
Yes—The client meets the local definition of basic literacy skills deficient. This must be determined to include:
1. Computes or solves problems, reads, writes or speaks English at or below grade level 8.9; or
2. Is unable to compute or solve problems, read, write, or speak English at a level necessary to function on
the job, in the individual’s family or in society.
No – There are no basic skills deficiencies to impede the functioning of the client.
N/A – Information on this item is not available.
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May 2010
28 Offender
Yes—The client (adult or juvenile) who is or has been subject to any stage of the criminal justice process, for
whom WIA services may be beneficial OR who requires assistance in overcoming artificial barriers to
employment resulting from a record of arrest or conviction.
No – The client has not been subject to any stage of the criminal justice process.
29 Pregnant / Parenting
Youth
Yes—The client is under 22 years of age and is pregnant, or a youth (male or female) that provides custodial care
for a minor child.
No – The client either is not a parent or caregiver for a custodial child, or is older than 22 years of age at the time
of application into WIA.
30 Youth Needing
Additional Assistance
Local policy establishes the criteria for what constitutes additional barriers to completing an educational program
or securing employment. Local policy includes the following additional barriers to employment as: (one or more
of the below listed criteria must be met). These criteria define youth who require additional assistance to
complete an educational program or to secure and hold employment.
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
Youth who are at risk of dropping out of school
Youth with disabilities
Immigrant or refugee youth
Youth with limited English proficiency
Youth with a family history of chronic unemployment
Gang affiliated youth
Youth who reside in areas with high rates of poverty, crime and/or unemployment
Have a substance abuse problem or history of having such a problem
Former Foster Care
Parent or guardian is incarcerated
Is being raised by someone other than biological parents such as kinship care
First-generation high school graduate
Select from the following based on the above-mentioned local policy. For those barriers for which there is a
separate data item (i.e. youth with disability) in addition to this item, please be sure to answer both items
appropriately.
Yes—The client is between 14 and 21 years of age and requires additional assistance to complete an educational
program, or to secure and hold employment.
No – The client is either over the age of 21 or does not have any of the barriers identified in the local policy.
31 At Risk of Dropping
Out
High School Definition: A youth who meets one or more of the following criteria:
a. Two grades below his/her age group
b. Youth displays indicators of a high potential to drop out. These can be based upon policies that have
been adopted by the Local Education Agency (LEA) as criteria for identifying potential dropouts
including the following:
Not able to obtain work permit due to low GPA
Below 2.0 GPA or is on their school’s D and F list.
Has failed to pass the California High School Exit Exam (CAHSEE)
Below minimum number of required credits for grade level
Chronic attendance problems
Disciplinary issues (e.g. suspensions, expulsions or other documented behavioral issues
resulting in a disciplinary action)
32 Family History of
Chronic Unemployment
a)
Youth or family member has a “poor employment history” (or underemployed)- Employment has been
limited to one or more part-time (20 hours per week or less), or short-term (four months or less), jobs within
the prior year, which were for the purpose of income maintenance rather than a career path (i.e., the jobs
were “dead end” type jobs which would not prepare the individual for permanent reemployment in the
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May 2010
b)
c)
d)
previous industry or occupation);
Unemployment insurance and/or public assistance receipt in the prior year, with little or no employment in
interim periods, indicating a poor work history.
Meets the local self-sufficiency measure for employed adults (Family income is below 150% of the LLSIL).
Meets the definition of long-term unemployed - Any one who at some time was connected to the workforce
and is:
1. Unemployed at the time of application for eligibility determination; and
2. Has been unemployed for 15 or more of the 26 weeks immediately prior to such determination; or
3. Has been laid off and meets the definition of underemployed with a poor work history since the layoff
has only earned below 70% of pre-dislocation wage;
4. Has limited opportunities for employment or reemployment in the same or similar occupation in the
area in which such individuals reside, including older individuals who may have substantial barriers to
employment by reason of age.
UNDEREMPLOYED
Underemployed means an individual who is working part time, but desires full time employment or who is
working in employment not commensurate with the individual’s demonstrated level of educational attainment.
Reference Operations Issuance 2007-12 Chapter VII Eligibility Certification Process, for determining eligibility
under the above criteria.
33 Gang Involved or
Affected
A youth with one or more of the following characteristics:
a) Admits membership in or close affiliation with a gang
b) Desires to be initiated into a gang
c) Has tattoos and/or paraphernalia associated with a specific gang
d) Has been arrested in the company of a known gang member while committing a delinquent or
criminal act
e) Has been confirmed as a gang member by police records, observances, and/or informants
f) Have family members who are gang-affiliated as outlined above
34 Immigrant or
Refugee
Immigrant - See Permanent Resident Alien
Permanent Resident Alien - an alien admitted to the United States as a lawful permanent resident and issued
immigrant visas by the Department of State overseas or adjusted to permanent resident status by the Immigration
and Naturalization Service in the United States.
Refugee - Any person who is outside his or her country of nationality who is unable or unwilling to return to that
country because of persecution or a well-founded fear of persecution. Refugees are subject to ceilings by
geographic area and are eligible to adjust to lawful permanent resident status after one year of continuous
presence in the United States.
Note: Legal status is required for both criteria.
Definitions from the U.S. Citizenship and Immigration Services Glossary – formerly called the Immigration and
Naturalization Services (INS). The definition refers to Permanent Resident Alien.
35 Reside in areas with
high rates of poverty,
crime and
unemployment
Youth who live in an area that is:
a) A designated federal or state Empowerment or Enterprise Zone* area
b) An area designated or identified by law enforcement (police dept., DA or City Attorney) as a “gang
injunction” safety zone
c) One of the following based upon census tract (use the Local Data information provided as Attachment B to
this issuance:
•
Lives in an area with an unemployment rate of 6% or more. (Attachment B - Appendix 1)
•
An area that has 1 ½ times above the County average number of residents over the age of 25 who do not
have a HS diploma (Attachment B -Appendix 2)
•
An area that has 1 ½ times above the County average number of residents living below federal poverty
level. (Attachment B – Appendix 3)
Reference Operations Issuance 2006-11, Attachment B Local Barrier Data for determining eligibility under the
above criteria.
*An Enterprise Zone is a defined geographic area in which businesses can claim certain state income tax savings
and other advantages. Enterprise Zones were created in California to stimulate business investments in areas that
32
May 2010
are economically disadvantaged as well as spur job growth in areas of high unemployment. The state of California
has designated 39 locations as Enterprise Zones. Two are located in the City of San Diego, 1) Metropolitan
Enterprise Zone located south and east of downtown, adjacent to the bay; and, 2) South Bay Enterprise Zone is
located in the City's South Bay area along the U.S.-Mexico border and in parts of the City of Chula Vista.
36 Substance Abuse
Problem or History
The use of alcohol and/or drugs to the extent that an individual’s ability or behavior is diminished and creates a
barrier to employment.
37 Former Foster Care
Youth who was a foster care ward in the past 24 months.
38 Parent, Guardian or
Sibling is Incarcerated
Youth whose parent, guardian or sibling is subject to any stage of the criminal justice process resulting from a
record of arrest or conviction, and is subject to incarceration or confinement in a local, state or federal detention
facility.
39 Is being raised by
someone other than
biological parents
Youth who lives with and is being cared for by a grandparent, aunt or uncle, sibling or some other relative — a
living arrangement commonly referred to as "kinship care" — because their own parents were unavailable or
unable to care for them.
40 Would be firstgeneration high school
graduate
Youth whose parents or guardian(s) have not attained a high school diploma or its recognized equivalency.
41 Runaway Youth
Yes—The client is a youth ages (14-17) who absents his or herself from home or place of legal residence without
the permission of parents or legal guardian.
No – The client is emancipated, is no longer a youth, or is not a runaway youth.
42 Foster Child
Yes—The client is a foster child on behalf of whom State or local government payments are made.
No – The client is either not a youth (over 18), or is not currently involved with the foster care system.
43 Family TANF
Yes—The client is listed on the grant and/or is receiving assistance under the Temporary Assistance to Needy
Families (TANF) program at any time during WIA participation. Also include participants referred by the TANF
agency, participated in the TANF assessment program as a requirement prior to opening a TANF grant, and who
received support services from the TANF agency.
No-- The client is not listed on the grant and/or is not receiving assistance under the Temporary Assistance to
Needy Families (TANF) program.
44 Family GA
Yes—The client is listed on the grant and/or is receiving cash assistance under a General Assistance program.
No —The client is not listed on the grant and/or is not receiving cash assistance under a General Assistance
program.
45 Family RCA
Yes—The client is listed on the grant and/or is receiving cash assistance under a Refugee Cash Assistance
program.
No –The client is not listed on the grant and/or is not receiving cash assistance under a Refugee Cash Assistance
program.
46 Family SSI
Yes—The client is listed on the grant and/or is receiving cash assistance under the Supplemental Security Income
program (SSI-SSA Title XVI).
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May 2010
No—The client is not listed on the grant and/or is not receiving cash assistance under the Supplemental Security
Income program (SSI-SSA Title XVI).
47 Family Food Stamps
Yes, Eligible—The client has been determined to be eligible to receive food stamps pursuant to the Food Stamp
Act of 1977 (7 USC 2011 et seq.) within the 6-month period prior to WIA Application.
Yes, Receiving—The client receives, or is a member of a family that receives food stamps pursuant to the Food
Stamp Act of 1977 (7 USC 2011 et seq.)
No—Not eligible.
48 Number in Family
Enter the total number of family members, as defined in WIA, including the client, in the individual’s household.
Include family members who are voluntarily and temporarily residing elsewhere, for example, attending college
or visiting relatives. A stepchild or stepparent is considered to be related by marriage.
49 Number of
Dependents < Age 18
Enter the number of the client's dependents that are under the age of 18.
50 Family Status
Parent in one-parent family - A single, abandoned, separated, divorced, or widowed parent who supports one or
more dependent children under 18, residing in the same residence.
Parent in two-parent family - An individual who, with his or her spouse, shares custodial support for one or
more dependent children, residing in the same residence.
Other family member - An individual who is living with his or her family of two or more persons and is not a
parent.
Not a family member - An individual who is not living with his or her family. This may be an individual who is:
a. Homeless;
b. Disabled, living with his or her family or not;
c. A foster child, on behalf of who State and local government payments are made;
d. A single individual living alone.
e. Court Adjudicated youth separated from the family (including incarcerated youth), homeless,
runaway, and emancipated youth.
Not reported
51 Family Income Prior
Six Months
Enter the whole dollar amount that the client (or client’s family if a family member) received as gross income, for
the six-month period prior to WIA Application. Exclude unemployment compensation, child support payments,
public assistance program payments, and old age and survivors insurance benefits received under Section 202 of
the Social Security Act (42 USC 402).
Please see the Operations Manual, Chapter VII, WIA Eligibility Certification Process Part III, D, (3) for a
list of income to be included and excluded in determining family income.
52 Low Income
An applicant’s income status is necessary to determine the appropriate WIA eligibility. A client who is disabled,
as noted in the Disabled field, should exclude the income of family members.
Use the following in determining if the client is Low Income.
a. The client receives, or is a member of a family which receives, cash payments under a Federal, State,
or income-based public assistance program;
b. The client receives an income, or is a member of a family that received a gross family income,
[exclusive of unemployment compensation, child support payments, public assistance program
payments, and old-age and survivors insurance benefits received under Section 202 of the Social
Security Act (42 USC 402)], for the six-month period prior to WIA Application that, in relation to
family size, does not exceed the higher of:
1. The poverty guideline for the equivalent period; or
2. 70 percent of the lower living standard income level for an equivalent period;
c. The client is a member of a household that receives (or has been determined within the six-month
34
May 2010
period prior to Application for the program involved, to be eligible to receive) Food Stamps pursuant
to the Food Stamp Act of 1977;
d. The client is a homeless individual (see field definition for Homeless);
e. The client is a foster child on behalf of whom State or local government payments are made;
f. The client is an individual with a disability who meets the requirement of a program described in A or
B above, but who is a member of a family that does not meet such requirements.
Please see the Operations Manual, Chapter VII, WIA Eligibility Certification Process Part III, D,
(3) for a list of income to be included and excluded in determining family income.
53 TANF Exhaustee
Yes—The client has exhausted all TANF benefits for which the individual has been determined eligible.
No – All other circumstances.
54 Homeless
Yes—The client lacks a fixed, regular and adequate nighttime residence; OR has a primary nighttime residence
that is a supervised publicly or privately operated shelter designed to provide temporary living accommodations;
OR is residing in a public or private place not designed for, or ordinarily used as a regular sleeping
accommodation for human beings.
No—The above condition is not met.
55 Poor Work History
Yes—The client has not worked full-time in unsubsidized employment for more than 13 consecutive weeks in the
last 12 calendar months.
No-- The client has worked full-time in unsubsidized employment for more than 13 consecutive weeks in the last
12 calendar months.
56 Unemployment
Insurance
Yes, Claimant—The client is currently receiving unemployment compensation.
Yes, Exhaustee—The client was receiving unemployment compensation, but has exhausted claim benefits.
No – Neither of the above two conditions applies to the client.
57 Veteran Status
Yes, Less than or equal to 180 days—The client served in the active US military, naval, army, coast guard,
marines or air service, for a period less than or equal to 180 days, and who was discharged or released from such
service under conditions other than dishonorable.
Yes, Greater than 180 days—The client served as above for greater than 180 days.
No -- Neither of the above two conditions applies to the client.
58 Disabled Veteran
Yes—The client is a veteran entitled to disability compensation under Department of Veterans’ Affairs (DVA)
laws or was discharged or released from active duty because of a service-connected disability.
Yes, special disabled—The client is rated at 30 percent disabled or more by the DVA, or at 10 or 20 percent for a
serious employment disability.
59 Recently Separated
Veteran
Yes—The client is a veteran who applied for WIA participation within 48 months after discharge or release from
active US military, naval, army, coast guard, marines or air service.
No –The above condition does not apply to the client.
60 Veteran Separation
Date
Enter the date the client was discharged or released from active US military, naval, army, coast guard, marines or
air service.
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May 2010
61 Campaign Veteran
Vietnam-Era—The client is a veteran who served in the active US military, naval, army, coast guard, marines or
air service, and who was discharged or released from such service under conditions other than dishonorable
during the Vietnam-era. (The period beginning on February 28, 1961, and ending on May 7, 1975, in the case of a
veteran who served in the Republic of Vietnam during that period and the period beginning on August 5, 1964,
and ending on May 7, 1975, in all other cases).
Other Veteran—The client is a veteran who served on active duty in the US armed forces during a war or
campaign or expedition for which a campaign badge or expeditionary medal has been authorized. (See following
campaign list.)
AUTHORIZED CAMPAIGN LIST
Armed Forces Expeditionary Medal (AFEM)
Berlin- Aug. 14, 1961 to Jun. 1, 1963
Bosnia - Nov. 20, 1995 to Dec. 20, 1996 & Dec. 20, 1996 to present
Cambodia - Mar. 29, 1973 to Aug. 15, 1973
Cambodia Evacuation -Apr. 11 – 13, 1975
Congo - Jul. 14, 1960 to Sept. 1, 1962 & Nov. 23 –27, 1964
Cuba - Oct. 24, 1962 to Jun. 1, 1963
Dominican Republic - Apr. 28, 1965 to Sept. 21, 1966
El Salvador - Jan. 1, 1981 to Feb. 1, 1992
Grenada - Oct. 23, 1983 to Nov. 21, 1983
Haiti - Sept. 16, 1994 to Mar. 31, 1995
Iraq - Jan. 1, 1997 to present
Korea - Oct. 1, 1966 to Jun. 30, 1974
Laos - Apr. 19, 1961 to Oct. 7, 1962
Lebanon - Jul. 1, 1958 to Nov. 1, 1958 & Jun. 1, 1983 to Dec. 1, 1987
Mayaquez Operation - May 15, 1975
Operations in the Libyan Area - Apr. 12 – 17, 1986
Panama - Dec. 20, 1989 to Jan. 31, 1990
Persian Gulf Operation - Jul. 24, 1987 to Aug. 1, 1990
Persian Gulf Operation - Dec. 1, 1995 to present
Persian Gulf Operation - Dec. 1, 1995 to Feb. 1, 1997
Persian Gulf Operation - Nov. 11, 1998 to Dec. 22, 1998
Persian Gulf Operation - Dec. 16, 1998 to Dec. 22, 1998
Persian Gulf Intercept Operation - Dec. 1, 1995 to present
Quemoy and Matsu Islands - Aug. 23, 1958 to Jun. 1, 1963
Somalia - Dec. 5, 1992 to Mar. 31, 1995
Taiwan Straits - Aug. 23, 1958 to Jan 1, 1959
Thailand - May 16, 1962 to Aug. 10, 1962
Vietnam Evacuation - Apr. 29, 1975 to Apr. 30, 1975
Vietnam (including Thailand) - Jul. 1, 1958 to Jul. 3, 1965
Navy Expeditionary Medal & Marine Corps Medal
Cuba - Jan. 3, 1961 to Oct. 23, 1962
Indian Ocean/Iran - Nov. 21, 1979, to Oct. 20, 1981
Iranian/Yemen/Indian Ocean - Dec. 8, 1978 to Jun. 6, 1979
Lebanon - Aug. 20, 1982 to May 31, 1983
Liberia - Aug. 5, 1990 to Feb. 21, 1991
Libyan Area - Jan. 20, 1986 to Jun. 27, 1986
Panama - Apr. 1,1980 to Dec. 19, 1986 & Feb. 1, 1990 to Jun. 13, 1990
Persian Gulf - Feb. 1, 1987 to Jul. 23, 1987
Rwanda - Apr. 7 – 18, 1994
Thailand - May 16 – Aug. 10, 1962
Other Campaign & Service Medals
Army Occupation of Austria - May 9, 1945 to Jul. 27, 1955
Army Occupation of Berlin - May 9, 1945 to Oct. 2, 1990
Army Occupation of Germany (exclusive of Berlin) - May 9, 1945 to May 5, 1955
Army Occupation of Japan - Sept. 3, 1945 to Apr. 27, 1952
Chinese Service Medal (Extended) - Sept. 2, 1945 to Apr. 1, 1957
Korean Service - Jun. 27, 1950 to Jul. 27, 1954
Navy Occupation of Austria - May 8, 1945 to Oct. 25, 1955
Navy Occupation of Trieste - May 8, 1945 to Oct. 25, 1955
Southwest Asia Service Medal (SWASM) (Operations Desert Shield and Desert Storm) - Aug. 2, 1990
to Nov. 30, 1995
Units of the Sixth Fleet (Navy) - May 9, 1945 to Oct. 25, 1955
36
May 2010
Vietnam Service Medal (VSM) - Jul. 4, 1965 to Mar. 28, 1973
62 Spouse of Qualifying
Veteran
Yes -- The client is the spouse of:
• Any veteran who died of a service-connected disability;
• A member serving on active military duty who is listed as missing in action, captured in the line of duty
by a hostile force, or forcibly detained or interned in the line of duty by a foreign government or power;
• Any veteran with a total service-connected disability rating or one who died while being evaluated for
it. (Pub.L.107-288 Sec. 4215)
No -- None of the above conditions applies to the client.
63 Licensed Health Care
Professional/ Current
Certification
This field is no longer in use.
64 Incumbent Worker
Verification Letter
65 Highest Degree
Attained
Select the highest degree that the client has attained.
66 Education Status
Select the Education Status at Application from the following categories.
•
•
•
•
•
High School Diploma
GED or Equivalent
Associates Degree
Bachelors Degree
Masters or Doctorate Degree
For WIA-enrolled Youth, categorizations of “In-School” or “Out-of-School” are based on their education status,
plus, in some cases, Basic Skill Deficiency. Those In-School/Out-of-School categorizations are noted at the end
of each definition, and apply to Youth only.
Student, H.S. or less - The client is not a high school graduate (or equivalent) and is attending any school
(including elementary, intermediate, junior high school, secondary or postsecondary school) or is between school
terms and intends to return to school.
WIA-enrolled Youth categorized as In-School.
Student, attending Alternative School – The client is attending alternative secondary school.
Student, attending postsecondary school - The client is a high school graduate (or equivalent) and is attending
postsecondary school or is between school terms and intends to return to school.
WIA-enrolled Youth categorized as In-School, unless also Basic Skill Deficient, in which case they would
be categorized as Out-of-School Youth. Basic Skill Deficient is captured in field 26 of the WIA
Application.
Out-of-School, H.S. dropout - The client is not attending any school and is not a high school graduate.
WIA-enrolled Youth categorized as Out-of-School Youth.
Out-of-School, H.S. graduate, employment difficulty - The client is not attending any school, is a high school
graduate, and is basic skills deficient, unemployed, or underemployed.
Out-of-School, H.S. graduate, no employment difficulty - The client is not attending any school, is a high
school graduate and is not basic skills deficient and not unemployed and not underemployed.
WIA-enrolled Youth categorized as In School Youth (by default).
37
May 2010
67 Highest Grade
Completed
Enter the highest-grade number that applies to the client.
Enter 00 if the client did not complete any school grades.
01-11 Enter the number of elementary/secondary grades completed. Individuals who completed 12th grade but
did not receive a diploma or equivalent are to be coded 11.
•
Disabled participants who received a Certificate of Completion or an IEP (Individual Education Plan)
diploma are to be coded as 11.
12 High School graduate
88 Attained certificate of equivalency for a high school degree.
13-15 If a high school graduate, the number of school years completed including college or full-time technical or
vocational school.
16 Bachelor’s degree or equivalent.
17 Education beyond a Bachelor’s degree (including a Master’s degree, Ph.D. or equivalent.)
68 Read Grade
Enter the client's grade level equivalent between 0.1 and 12.9 in English reading as determined by a generally
accepted standardized or criterion-referenced test (administered within the last twelve months) or a school record
of reading level (administered within the last twelve months). This grade level should be used to determine
whether a client is Basic Skills Deficient (see item #27).
Enter 13 for individuals whose test level is at grade 13 or above.
Enter 87 for individuals who were not tested and are obviously below the ninth grade level.
Enter 88 for individuals who refused testing or who otherwise could not be tested or for whom testing was not
needed.
Enter 89 for individuals whose highest grade is 16 or above.
69 Read Score
Enter the participant’s raw score in reading English as determined by a generally accepted standardized or
criterion-referenced test.
70 Reading Test
Enter the appropriate answer from the list of tests. If a raw score is reported in the reading proficiency score,
select the test that was administered.
71 Math Grade
Enter the client's grade level equivalent between 0.1 and 12.9 in math as determined by a generally accepted
standardized or criterion-referenced test (administered within the last twelve months) or a school record of math
level (administered within the last twelve months). This grade level should be used to determine whether a client
is Basic Skills Deficient (see item #27).
Enter 13 for individuals whose test level is at grade 13 or above.
Enter 87 for individuals who were not tested and are obviously below the ninth grade level.
Enter 88 for individuals who refused testing or who otherwise could not be tested or for whom testing was not
needed.
Enter 89 for individuals whose highest grade is 16 or above.
72 Math Score
Enter the participant’s raw score in math as determined by a generally accepted standardized or criterionreferenced test.
38
May 2010
73 Math Test
Enter the appropriate answer from the list of tests. If a raw score is reported in the math proficiency score, select
the test that was administered.
74 Labor Force Status
Employed—An employed individual:
A. Has done any work at all as a paid employee, in his or her own business, profession or farm, during
the last 7 days prior to WIA application; or
B. Has done 15 or more hours as an unpaid worker in an enterprise operated by a member of the family
during the last 7 days prior to WIA application; or
C. Has a job or business from which he or she is temporarily absent because of illness, bad weather,
vacation, labor-management dispute, or personal reasons, whether or not paid by the employer for timeoff, and whether or not they are seeking another job, during the last 7 days prior to WIA application.
Not employed—The client does not meet the definition of employed above, or who, although employed, has
received notice of termination of employment.
75 Weeks Not Employed
Last 26 Weeks
Enter the number of weeks (0-26) that the client was unemployed during the 26 weeks immediately before
applying for WIA. Enter this information whether or not the individual is unemployed at the time of application.
76 Hourly Wage
Enter the hourly wage of the client. If the individual is paid by commission or receives a salary, convert to the
hourly wage by dividing the amount paid by the number of hours the individual is expected to work. The term
hourly wage includes any bonuses, tips, gratuities, commissions, and overtime pay earned.
If only a yearly salary is provided, AND the employee’s hours per week is known, divide the salary by the
projected annual hours worked to arrive at the hourly wage. If the employee is known to be working 40 hours per
week, an estimate of 2080 hours per year should be used. For example, if a client’s salary is only known as
$32,000 a year, working 40 hours per week, to compute the hourly wage divide $32,000 / 2080 hours = $15.38 an
hour.
The hourly wage collection should be consistent with the manner that the hourly wage is collected on the followup form in order for these figures to be used in estimating the earnings gains for the client.
77 Hours per Week
78 Referred by WPRS
Select “Yes” if the client is an unemployment insurance claimant who has been referred to WIA reemployment
services by the Worker Profiling and Reemployment Services (WPRS) system. Locally this may be known as the
Initial Assistance Workshop (IAW).
79 Dislocated Worker
Please select the type of dislocated worker from the following list:
•
•
•
•
•
•
Terminated or Laid off or voluntarily terminated employment and is eligible for unemployment
compensation.
Received Notice of Layoff
Long Term Unemployed (JTPA Transfers or NEG Fire Disaster Grant only)
Self Employed
Displaced Homemaker
Not Applicable
80 Job Code at
Dislocation
Use the job code that best describes the individual’s type of employment. This code should represent the job code
for which the individual is most skilled or the one for the job held the longest. Record the SOC code that best
describes the individual’s type of employment as well as the title of the job. The job code will auto-fill the Job
Title field.
81 Dislocation Date
Enter the last day of employment at the dislocation job. If there is no dislocation job, (e.g., displaced
homemakers), leave blank. If the individual is still employed, this field should be left blank until the qualifying
dislocation takes place.
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May 2010
82 Tenure at Employer
of Dislocation
Enter the number of months the client was employed at the place of dislocation.
83 Dislocation Industry
Code
Enter the first three-digits of the North American Industry Classification System (NAICS) industry code of the
qualifying dislocation.
84 Employer Number /
Address
Use of the Employer number automatically fills in the gray areas of the form including Employer Name,
Employer Address, Employer City, State, and Employer Zip. This information is pulled from the Employer
Database in CISRS and should reduce data entry time when entering Placement Information. It is possible to
search by many criteria including the city, business name, and employer number if known. For example if a
client is placed at “Ralph’s”, a search of the employer name “Ralph’s” may return several entries, by selecting the
correct store, all of the accompanying information will be entered into the form including the employer number.
85 Employer Phone
Record the employer’s contact telephone number including the area code. Do not leave this item blank.
Self-Sufficiency Determination: Fields 86-92 are used in the determination of self-sufficiency for the consideration of eligibility
of an employed individual, who may not otherwise be eligible for WIA programs.
86 Part Time
Employment
Select “Yes” if the client is working less than 32 hours per week. If the client is working 32 hours per week or
more select “No.”
87 Seasonal
Employment
Select “Yes” if the client is working in a seasonal job. If the client is not working in a seasonal job select “No”.
88 Temporary
Employment
89 Current Hourly
Wage
90 Pre Dislocation
Hourly Wage
Seasonal employment may include summer life guard, holiday retail help, or other time limited employment.
Select “Yes” if the client is working in a temporary job. If the client is not working in a temporary job select
“No”.
Enter the current hourly wage of the client, if applicable. If the individual is paid by commission or receives a
salary, convert to the hourly wage by dividing the amount paid by the number of hours the individual is expected
to work. The term hourly wage includes any bonuses, tips, gratuities, commissions, and overtime pay earned.
hour.
If the client meets the definition of a dislocated worker within the past year, the client’s hourly wage before
dislocation.
If the individual is paid by commission or receives a salary, convert to the hourly wage by dividing the amount
paid by the number of hours the individual is expected to work. The term hourly wage includes any bonuses, tips,
gratuities, commissions, and overtime pay earned.
hour.
91 Health Benefits
Yes - Use if the employment provides the individual with health insurance benefits.
No - Use if the employment DOES NOT provide the individual with health insurance benefits.
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May 2010
92 Non-Custodial Parent
Yes –The client is the non-custodial parent of a child who is receiving, or whose custodial parent is receiving,
TANF/Cal Works assistance.
No -The above condition is not met.
93 Eligibility
Click the Calculate Eligibility button to have the system recommend eligibility based on the answers provided on
the completed Application.
Adult WIA
The client is eligible for the Adult program if the individual is age 18 or older.
Adult Low Income
The client is eligible for the Low Income Adult program if the individual is age 18 or older AND is indicated as
low income on the WIA Application. - WIA Section 134 (d)(4)(E)
PRIORITY: In the event that funds allocated to a local area for adult employment and training activities under
paragraph (2)(A) or (3) of Section 133(b) are limited, priority shall be given to recipients of public assistance and
other low-income individuals for intensive services and training services.
Dislocated Worker
The client is eligible for the Dislocated Worker program (WIA Section 101(9)), if the following criteria have been
met.
1. Has been referred through California’s Worker Profiling and Re-employment Services system. Initial
Assistance Workshop (IAW) invitee.
2. Has been terminated or laid off, voluntarily terminated, or has received a notice of termination or layoff from
employment; and is eligible for, or has exhausted, entitlement to unemployment compensation; or is not eligible
for unemployment compensation due to insufficient earnings or having performed services for an employer that
was not covered under a State unemployment compensation law, but demonstrates a sufficient attachment to the
workforce (WIA Section 134(c)); and Is unlikely to return to a previous industry or occupation.
3. Substantial Layoff: Individuals who have been terminated or laid off, or have received a notice of termination
of employment, because of any permanent closure of, or any substantial layoff at a plant, facility or enterprise.
Plant, Facility or Enterprise are defined as a distinct unit of business or industry; for example, the closure of a
division of a corporation, the entire facility at a specific site or location, or the closure of a functional unit, such as
a warehouse. A change in ownership in itself does not constitute a closure; however, it may cause a “substantial
layoff.”
4. Public Closure: Workers at a facility, which the employer has made a public announcement that such facility,
will close within 180 days, and who have not received a specific notification of termination or layoff. These
individuals, excluding those likely to remain employed with the employer or who are likely to retire, can receive
the following:
a)
b)
Basic readjustment services, except for supportive services and relocation assistance, from the
date of the public announcement;
Allowable basic readjustment, retraining and supportive services beginning 180 days before
the date on which the facility is scheduled to close.
5. Self-Employed: Was self-employed (including employment as a farmer, a rancher, or a fisherman) but is
unemployed because of general economic conditions in the community in which the individual resides or because
of natural disasters. *Note that the unemployment of the formerly self-employed individual cannot be merely the
result of poor business practices by the individual.
6. Displaced Homemaker: A displaced homemaker is an individual who has been providing unpaid services to
family members in the home and who:
a.) Has been dependant on the income of another family member but is no longer supported by that
income; and
b.) is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading
employment.
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May 2010
Youth (14-18) or Youth (19-21)
The client is eligible for Youth services (WIA Section 101(13)), if the following criteria have been met:
Is a low income individual, as defined in WIA Section 101(25); AND Is within one or more of the following
categories:
a. Deficient in basic literacy skills; OR
b. High School dropout; OR
c. Homeless, runaway, or foster child; OR
d. Pregnant or parenting; OR
e. An offender; OR
f. Is an individual (including a youth with a disability) who requires additional assistance to complete an
educational program, or to secure and hold employment (WIA Section 101(13)). (See item 29 of this
form for local definition)
Youth will automatically be categorized on the Application Eligibility screen as either “Youth (age 14-18)”, or
“Youth (age 19-21)”, as determined by their date of birth on the WIA Application.
5% Window Youth
The client is eligible for Youth services within the 5 percent window (WIA Section 129(c)(5)), if not more than 5
percent of participants being assisted under youth funds are individuals who do not meet the minimum income
criteria, as noted in Low Income on the WIA Application, to be considered eligible youth.
Such individuals must be within one or more of the following categories:
a. Deficient in basic literacy skills; OR
b. High School dropout; OR
c. Homeless, runaway, or foster child; OR
d. Pregnant or parenting; OR
e. An offender; OR
f. Is an individual (including a youth with a disability) who requires additional assistance to complete an
educational program, or to secure and hold employment (WIA Section 101(13)). (See item 29 of this
form for local definition)
Youth will automatically be categorized on the Application Eligibility screen as either “5% Window Youth (age
14-18)”, or “5% Window Youth (age 19-21)”, as determined by their date of birth on the WIA Application.
Veteran Grant
The client is eligible for Veteran services (WIA Section 168), if the following criteria have been met:
The client is eligible as an individual who served in the active military, naval, army, coast guard, marines or air
service, and who was discharged or released from such service under conditions other than dishonorable; AND
Is within one or more of the following categories:
a. Service-connected disability; OR
b. Significant barrier to employment; OR
c. Campaign veteran; OR
d. Recently separated veteran.
Not Eligible
The client is ineligible for the all programs.
94 Are all Docs
Received?
95 Interviewer
96 Interview Date
97 Reviewer
Select “Yes” if all documents have been received, copied, filed, and recorded in the documents form in CISRS.
The interviewer is the person responsible for completion of this form. The reviewer ID certifies that the proper
eligibility has been determined for the WIA program.
Enter the date the Interviewer initiated the Application.
The reviewer is the individual responsible for reviewing the application form. The reviewer ID certifies that the
proper eligibility has been determined for the WIA program.
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98 Review Date
Enter the date the Reviewer certifies that the proper eligibility has been determined for the WIA program. The
review date must be before enrollment. This is the date of eligibility determination.
99 Agency Name
The system records the agency name associated with the logged in user that entered this original record. The user
should check to make sure the agency name reflects the name of the appropriate agency.
100 Contract Code
The system records the contract code associated with the logged in user that entered this original record. The user
should check to make sure the contract code reflects the name of the appropriate contract.
101 Is Form Complete?
102 Change Log
103 Fill DESN
Select “Yes” if all of the required fields of the form have been completed.
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Chapter 3
Document Verification Form
The Documents Form in CISRS is used to record the type of documentation used to verify
required eligibility items. Upon completing the CISRS Application, the individual will be
asked to provide documentation in support of all information required for eligibility that is
contained on the Application Form. Acceptable documents that can be used to verify
eligibility criteria are listed in the Workforce Partnership’s Operations Manual, Chapter VII
Acceptable Documentation Table (Attachment E-1 and 2). Each item has a number of
documents that can be used to verify the validity of the eligibility item. Please use the
Acceptable Documentation Table to determine the appropriate documents required to verify
each item.
The purpose of the verification process used by intake staff is to determine and record the
validity of the eligibility information collected, pertaining to all programs for which an
individual is planning to receive services. Documentation means to maintain on-file physical
evidence obtained during the verification process. Such evidence would be copies of
documents, completed Telephone Verification/Document Inspection Forms or Applicant
Statements.
The local requirement is that the internal review of eligibility certification must be prior to
the applicant’s enrollment into WIA staff-assisted services.
The use of this form is mandatory.
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1
2
3
4
5
6
7
8
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1 Eligibility Item
Select the type of document received.
2 Verification Source
Identify which acceptable documentation source was examined and/or copied by the person verifying eligibility for
each of the eligibility items required for the program(s) for which the client is eligible.
3 Verify Status
Confirm here that the verification and documentation sources have been examined by the eligibility specialist.
4 Review Status
Confirm here that the verification and documentation sources have been examined by a second, internal reviewer,
who has validated that the eligibility verification process is complete and correct.
5 Document Location
Enter the location where the document is filed.
6 Receive Date
Enter the date that the document was received, photocopied, and filed.
7 Verified By
The interviewer who verifies that the proper documentation has been collected. This field will be automatically
filled with the name of the person logged into the system. The user should check to ensure that the name entered
matches the name of the individual that should be the staff member responsible for verifying the document.
8 Reviewed By
The second reviewer who verifies that the proper documentation has been collected. This field will be automatically
filled with the name of the person logged into the system. The user should check to ensure that the name entered
matches the name of the individual that should be the staff member responsible for reviewing the document.
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Chapter 4
Alternate Contact Form
The Alternate Contact Form is used to record additional and alternate contact information for
a customer. It is mandatory that a minimum of two contacts are recorded.
This information is used in the event that the customer cannot be reached through their
primary contact information or contact is lost with the registered participant. It is imperative
that continuous contact be maintained with clients for the purpose of providing services,
obtaining placement and follow-up information, and for customer satisfaction surveys.
Dependable alternate contact information is vital to the success of the client and the provider.
Recommended alternate contacts include parents and grandparents who are less likely to
move as often as customers. Provider staff shall not be listed as an alternate contact.
1
2
3
4
5
6
7
8
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1 Contact Name
Enter the first and last name of the alternate contact. If you are entering an alternate telephone number for the
client, enter type of alternate contact phone (e.g. Mobile, Office, FAX).
2 Relation Type
Choose the relation of the alternate contact. If the relation type does not appear on the drop-down list, select
other and enter the relation type in the next field.
Select Self, if you are entering an alternate telephone number for the client.
3 Other Relation Type
If Other was selected in the “Relation Type” field, enter the type of relationship here. If a relation type was
selected from the drop-down list in the previous field, this field should be left blank.
4 Address
Enter the address of the contact. If there is only an alternate telephone number for the client, this field may be
left blank.
5 City, State Zip
Enter the zip code of the client, if known. By entering the zip code, the city and state fields will automatically
fill.
6 Phone
Enter the telephone number, including the area code, of the contact person or alternative client telephone.
7 Comments
Enter any note about the contact (e.g. available after 5PM).
8 Change Log
The system records the date and the name of the logged in system user that entered this original record. Then
the system records the date, time, and name of the user who last edited this particular record.
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Chapter 5
Workshop Form
The Workshop Form is used to sign-up and check-in customers who attend workshops at the
One-Stop Career Centers (scheduled in CISRS). Once a client is checked-in to a workshop,
the activity automatically populates the Service Record. By using this form, a case manager
can assist their clients in selecting and scheduling a workshop and verifying their attendance.
1
2
3
4
5
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1 Case Number
Select the case number corresponding to the enrollment under which services are being provided. The system
will default to “none”, if the participant is not enrolled.
2 Workshop
Information
Selecting from a list of workshops scheduled in CISRS will automatically fill the following 5 fields on the
Workshop Form:
•
•
•
•
•
3 Activity Code
Workshop title
Begin date
Begin time
Length in hours
Instructor
WKS, Workshops
This activity code will be used for all customers (regardless of their status) attending a Core A
Workshop.
Code 14, Staff Assisted Workshops/Job Clubs
ONLY registered participants may attend Core B Workshops. Activity Code (14) is used to identify
these workshops.
Core B/Staff Assisted Workshops differ from Core A Workshops in the amount of staff-assisted time
that is provided. Core B/Staff Assisted Workshops are specifically designed for and attended by
registered clients only. They are customized to the individual participant and may require follow-up
assistance beyond the classroom. For instance, a Core B Workshop may teach and review resume,
interviewing, job search strategies, in order to further assist in developing an employment plan.
Participants will receive more intensive and individualized help and critiques of their resumes and
other job search skills.
A Core B Workshop is classified as a Job Search Assistance Activity (Code 14). Job search assistance
(including job search skill training and job club activities) means the provision of instruction and
support to a participant to give the participant skills in acquiring full time employment. This is a one
day activity, the end date will auto-fill to match the begin date. The services provided by the
workshop may include, but are not limited to:
•
•
•
•
•
•
4 Workshop
Completion Status
Resume writing,
Interviewing skills,
Labor market guidance,
Telephone techniques,
Information on job openings,
Job acquisition strategies,
This field cannot be filled out until the scheduled workshop has occurred.
Complete Attendance
Select if the participant has attended the workshop.
No Attendance
Select if the participant did not attend the workshop.
9 Change Log
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Chapter 6
WIA Enrollment / Registration Form
The Workforce Investment Act (WIA) Enrollment/Registration Form is used to record the
enrollment of an eligible WIA client into the WIA grant program. Once a provider has
completed the intake/eligibility process, obtained the documentation required to determine
the client's eligibility for the program, and input the WIA Application Form into CISRS, an
Enrollment Form must be completed in order to enroll a participant into a Core B/Intensive,
Youth, or Training activity. Enrollment/Registration is the point at which information that is
used in performance measurements begins to be collected.
As part of the Enrollment process, a client must receive at least one Core B or Youth service
in order to be considered enrolled. Services/activities can be added through the “Group
Activities” screen or through the “Service Record” screen. Definitions of the
services/activities and their codes can be found in the Services/Activities chapter of this
handbook, along with instructions for completing the Group Activities screen.
The following are line item instructions for the Enrollment Form in CISRS. These
instructions are intended to assist with completion of the form. These instructions are not
intended to provide instruction on data entry and navigation steps for using CISRS. For these
instructions please refer to the CISRS Training User Guide.
Current eligibility criteria are outlined in Chapter VII of the San Diego Workforce
Partnership Operations Manual.
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1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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1 Case Number
The Case Number will automatically be assigned by the system.
The Application Number will automatically be assigned by the system.
3 Education Status
Select the Education Status at Application from the following categories.
For WIA-enrolled Youth, categorizations of “In-School” or “Out-of-School” are based on their education status,
plus, in some cases, Basic Skill Deficiency. Those In-School/Out-of-School categorizations are noted at the end of
each definition, and apply to Youth only.
(including elementary, intermediate, junior high school, secondary or postsecondary school) or is between school
terms and intends to return to school.
Student, attending postsecondary school - The client is a high school graduate (or equivalent) and is attending
postsecondary school or is between school terms and intends to return to school.
WIA-enrolled Youth categorized as In-School, unless also Basic Skill Deficient, in which case they would be
categorized as Out-of-School Youth. Basic Skill Deficient is captured in field 26 of the WIA Application.
Out-of-School, H.S. graduate, employment difficulty - The client is not attending any school, is a high school
graduate, and is basic skills deficient, unemployed, or underemployed.
Out-of-School, H.S. graduate, no employment difficulty - The client is not attending any school, is a high school
graduate and is not basic skills deficient and not unemployed and not underemployed.
WIA-enrolled Youth categorized as In School Youth (by default).
4 Basic Literacy Skills
Deficient
Yes—The client meets the local definition of basic literacy skills deficient. This must be determined to include:
3. Computes or solves problems, reads, writes or speaks English at or below grade level 8.9; or
4. Is unable to compute or solve problems, read, write, or speak English at a level necessary to function on
the job, in the individual’s family or in society.
No – There are no basic skills deficiencies to impede the functioning of the client.
5 Grant Code
Use the grant code of the WIA program in which the client is being enrolled. The system will only allow enrollment
into the grant codes for which the client has been determined eligible. Eligibility is determined from the WIA
Application field “Eligibility”.
Record the current employment status of the participant on the date enrolled/registered into a WIA program.
Employed - An employed individual is defined as one of the following:
A. Has done any work at all as a paid employee, in his or her own business, profession or farm, during the last
7 days prior to WIA enrollment / registration; or
B. Has done 15 or more hours as an unpaid worker in an enterprise operated by a member of the family during
the last 7 days prior to WIA enrollment / registration; or
C. Has a job or business from which he or she is temporarily absent because of illness, bad weather, vacation,
labor-management dispute, or personal reasons, whether or not paid by the employer for time-off, and
whether or not they are seeking another job, during the last 7 days prior to WIA enrollment / registration.
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Not Employed - The client is determined to be “Not employed” if the client does not meet the definition of
employed above, or who, although employed, have received notice of termination of employment.
7 Enrollment Date
The actual date that the client enrolled in the WIA program. This date cannot be prior to the WIA application date,
or after the date of the client’s first Core B or Intensive Activity. The system automatically generates this date as the
date of input. In an instance when the default of today’s date is not correct, please manually enter the correct date.
8 Date ITA
Established
Adults and Dislocated Workers
Enter the date that the Individual Training Account (ITA) was established for the client. The Date ITA Established
coincides with the date that the ITA Authorization is signed by the Career Center or Program Manager. WIA Title I
Adult and Dislocated Workers, CAC, and DESN-ODEP purchase training services from eligible providers they
select in consultation with the case manager.
This field must be completed once an ITA is established for a client. This field is not typically completed at the time
of enrollment. If an ITA is established for a client in the course of services, this field must be completed for the
client and the Enrollment Form updated.
This does not apply to WIA youth. This is an optional field and should be left blank if it does not apply.
9 Total Amount of
ITA
Record the total dollar amount of the ITA when the ITA is established. The amount may not to exceed the
established program limit. This amount may be updated at a later date if needed. For example, if an ITA is issued
for training that costs $3,800, the amount that should be entered is $3,800.00.
Note: The current program limit cap is set by the WIB. This amount is locally determined and the WIB has the
authority make changes to this cap.
This does not apply to WIA youth. This is an optional field and should be left blank if it does not apply.
10 Pell Grant
Recipient
Yes—The client is, or has been notified they will be receiving a Pell Grant.
No, Applied but denied —The client applied for a Pell grant, but was denied.
No, Application Pending —The client applied for a Pell grant, and is waiting for approval or denial.
No, Application not submitted—The client did not apply for a Pell grant.
This item may be updated at any time the individual is receiving WIA services (except follow-up services).
11 Pell Grant School
Year Award Amount
Enter the dollar amount of the Pell Grant that has been awarded to the client for the year.
12 NWI Program
Type
For those participants enrolled in the Nurse Workforce Initiative (NWI) Program only:
Select the program as appropriate:
LVN: Individual will upon completion of their training hold an LVN license
RN: Individual will upon completion of their training hold an RN license
Re-entry: Individual holds a valid license but needs a refresher course in order to practice with the license
held.
13 Case Manager
This field will automatically be filled with the name of the person logged into the system. The user should check to
make sure the name reflects the name of the case manager.
14 Enrolling Agency
The system records the agency name selected by the logged-in user on the CISRS home page. The provider should
check to make sure the agency name reflects the name of the appropriate agency.
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15 Contract ID
The system records the contract ID selected by the logged-in user on the CISRS home page. The provider should
check to make sure the contract ID reflects the name of the appropriate contract. If none was selected on the CISRS
home page, the user must select the appropriate contract ID here.
16 Change Log
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Chapter 7
Services, Activities and Case Notes
This chapter provides instruction on adding services/activities and case notes for a client into
CISRS, and definitions for each activity. Activities can be added to a client’s service record
two ways: through the “Add Group Activities” screen; or through the Service Record screen.
This chapter includes the codes and definitions for each of the services/activities, along with
instructions for completing the Group Activities screen.
There are several types of activities under WIA, and therefore within CISRS. Those types
include:
Activity Type
• Core A
• Core B
• Intensive
• Training
• Youth
• Post-Exit Youth
• Referral**
• Miscellaneous
Client Group
Adults* and Youth at One-Stop Career Centers
Adults
Adults
Adults
WIA-enrolled Youth
WIA-enrolled Youth who have been exited
Adults and Youth
Adults and Youth
* “Adults” refers to all non-Youth programs
** Only available through the Referral Form.
Within each of the activity types, there are a variety of activities. Depending on the activity
selected, CISRS may require different types of information, and therefore the screens will
look different. For example, some activities (i.e. training, supportive services, referrals and
youth work experience) require additional information through the “Detail” section. Screen
shots of those Detail screens are illustrated here in addition to the standard “Group
Activities” screen.
Case Notes are recorded in CISRS as an “activity”. There are two ways of adding a case
note. The first is in connection to the provision of a service: when the service is recorded in
CISRS, a case note may be added in conjunction with that activity record. The second is a
case note that is not connected to a specific service, for example when a case manager is
documenting an unsuccessful attempt to reach the customer. In this instance, a stand-alone
case note activity may be recorded in CISRS by adding one of several Core A-type activities
beginning with letters “CN__”. These activities will appear on the customer’s Service
Record, but are not considered a service to the customer. For more information on case
notes, see the description of Case Notes in section 10 of this chapter.
For WIA formula funded Adult and Dislocated Worker programs, clients must have at least
one Core B service before an Intensive service, and they must have at least one Intensive
service before a Training service.
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All services MUST have a reciprocal response from the customer. Leaving a message,
mailing a letter, or e-mailing a customer is NOT an activity unless the customer returns
the call, or responds to the letter or e-mail, or visits the center and acknowledges the
correspondence.
In some cases, services are provided to the customer by an outside service provider (not the
Workforce Partnership contracted service provider). For example, a customer may receive
substance abuse counseling from an independent provider. As long as the service is
coordinated and verified by the contracted service provider as part of the customer’s WIA
services, that service can and should be recorded in the customer’s Service Record. The
information on this service may come directly from the customer, or from the outside service
provider (in the example above, the counselor). The date that should be entered into CISRS
for the service, is the date when the service was actually provided, not the date of the contact
with the outside service provider.
Occasionally, a case manager may learn from a customer’s parent, spouse, teacher, or other
contact, that the customer has received a service from an outside service provider (other than
the contracted service provider). That service must be verified by either the customer, or
directly by the service provider that provided the service. A service reported by the parent,
spouse or other contact should not be recorded on the customer’s Service Record until it is
verified by the customer or the actual service provider. However, the contact with the parent,
spouse, etc, should be recorded as a Case Note.
These instructions are intended to assist with completing the information on the form/screen,
but are not intended to provide instruction on data entry and navigation steps for using
CISRS. For these instructions please refer to the CISRS Training User Guide.
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1
2
3
5
8
6
9
4
7
10
11
If a Training Activity Code is selected (50-60), the Detail link will connect to the following
information.
12
13
14
15
16
17
18
If Youth Activity Codes 700 (Youth Summer Work Exp) or 721 (Youth Work Exp) are
selected, the Detail link will connect to the following screen.
19
20
21
22
Subsidized
Unsubsidized
23
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If Miscellaneous Activity Code 81 (Supportive Services) or Youth Activity Code 760 (Youth
Supportive Services) is selected, the Detail link will connect to the following screen.
24
25
26
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May 2010
The application number is assigned automatically by the system.
2 Case Number /
Select Enrollment
The Case Number will automatically be assigned by the system, unless the participant is enrolled in more than one
grant, in which case, the user should select the appropriate enrollment.
3 Activity Type
Use the appropriate activity type. (Core A, Core B, Intensive, Training, Youth, Miscellaneous, Post-Exit) This
selection will drive the list of activity codes available.
4 Activity Code
Please use the appropriate Activity Code for the service provided. (Upon selecting the appropriate activity code, the
activity field will fill automatically.) A list of the Activity Codes and their descriptions are defined later in this
chapter.
5 Start Date
The date that the service/activity begins. The system automatically defaults the start date to the current date. This
can be changed to the appropriate date, if necessary.
6 Estimated End Date
The estimated or actual end date for the activity will automatically default to the start date for those activities that
are typically one day.
7 Actual End Date
The estimated or actual end date for the activity will automatically default to the start date for those activities that
are typically one day.
8 User
The system records the information for the user as logged in on the CISRS home page. The provider should check
to make sure the User name reflects the name of the appropriate user.
9 Completion Code
Completed – Use if client successfully completes the activity.
Not Completed, Involuntary -- The participant was separated from the program for administrative reasons (Use
this code if you have lost track of the participant for any open activities and it has been 90 day since the last service).
Not Completed, Voluntary – The participant voluntarily left the program or the participant did not complete the
activity.
10 Case Notes
The Case Notes field is used to record case notes in the participant’s CISRS file. Case notes record a narrative that
elaborates on services provided, planned activities, referrals, attempts to contact, and/or other important information
in a participant’s case file. The CISRS case notes are the only allowable/official case notes locally accepted to
document the services and activities conducted with a participant. Every case note is connected to a specific
activity. CISRS allows users to add on to an existing case note, but not to change the text of a case note once it has
been saved.
Services and activities shall always be supported by a case note that clearly and completely describes the
event/activity being documented so that it may be understood by anyone reviewing the note. Reviewers may
include other line staff, managers, Information Systems staff, Program Specialists, Monitors/Auditors, and other
pertinent professionals. Case notes should be concise, clear, spelled properly, and grammatically correct. Authors
of case notes with spelling and grammar difficulties are encouraged to use a word processor to develop their case
notes, and paste the text into the case notes form. Only commonly used and accepted acronyms and abbreviations
shall be used. Case notes should be professional, ethical, and objective. Case notes are part of the participant’s
legal file and may be used to determine the legitimacy of grievances or disputes.
11 Detail
Selecting this link opens up a new screen for the input of detail information about an activity. For example, some
activities (i.e. training, supportive services and youth work experience) require additional information through the
“Detail” section.
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Detail Screen Fields – Training Activity Type
- The following fields appear only if Training Activity Type is selected.
12 Training Type
13 Provider Code
Use the appropriate training type from the options of ITA training, Contracted training, OJT, Non-WIA funded
training, or Special Populations ITA training. This field is used only for training activities.
Select the provider code from the state and WIA provider codes list that identifies the school/agency that provided
the training activity. Leave this field blank for non-training activities, youth, customized training, work experience
or OJT enrollments, as it does not apply.
Selecting the Provider Code will auto-fill the Provider Name field.
14 Program Code
15 Job Code/Title
16 ITA Amount Used
For ITA training, record the 12-digit program code from the ETPL that identifies the program activity. Leave this
field blank for youth, customized training or OJT enrollments, and non-training activities, as it does not apply.
Entering the Program Code will auto-fill the Program Name field.
Use the job code that best describes the individual’s type of employment. Record the SOC code that best describes
the individual’s type of employment as well as the title of the job. The job code will auto-fill the Job Title field.
If the client is enrolled in training funded with an ITA, enter the total amount expended from the ITA with the final
amount expended. This field should be updated when the ITA invoice is processed (not when they are sent in).
- This field appears only if Training Activity Type is selected, and OJT or Customized Training Activity Code is
selected.
17 Employer Number/
Name
Use of the Employer number automatically fills in the gray areas of the form including Employer Name, Employer
Address, Employer City, State, and Employer Zip. This information is pulled from the Employer Database in
CISRS and should reduce data entry time when entering Placement Information. It is possible to search by many
criteria including the city, business name, and employer number if known. For example if a client is placed at
“Ralph’s”, a search of the employer name “Ralph’s” may return several entries, by selecting the correct store, all of
the accompanying information will be entered into the form including the employer number.
- This field appears only if Training Activity Type is selected, and OJT Activity Code is selected.
18 OJT Wage Subsidy
Enter the amount of the subsidized wage from the OJT.
Detail Screen Fields – Youth Work Experience Activities
- The following fields appear only if Youth Activity Type is selected, and Work Experience (721) or Summer Work Experience (700)
Activity Codes are selected.
19 Employer Number/
Name (Youth)
Use of the Employer number automatically fills in the gray areas of the form including Employer Name, Employer
Address, Employer City, State, and Employer Zip. This information is pulled from the Employer Database in
CISRS and should reduce data entry time when entering Placement Information. It is possible to search by many
criteria including the city, business name, and employer number if known. For example if a client is placed at
“Ralph’s”, a search of the employer name “Ralph’s” may return several entries, by selecting the correct store, all of
the accompanying information will be entered into the form including the employer number.
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Enter the hourly wage of the client. If the individual is paid by commission or receives a salary, convert to the
hourly wage by dividing the amount paid by the number of hours the individual is expected to work. The term
hourly wage includes any bonuses, tips, gratuities, commissions, and overtime pay earned.
If the Work Experience is unpaid, as in the case of some internships, a $0 should be entered here.
20 Wage
If only a yearly salary is provided, AND the employee’s hours per week is known, divide the salary by the projected
annual hours worked to arrive at the hourly wage. If the employee is known to be working 40 hours per week, an
estimate of 2080 hours per year should be used. For example, if a client’s salary is only known as $32,000 a year,
working 40 hours per week, to compute the hourly wage divide $32,000 / 2080 hours = $15.38 an hour.
21 Hours Per Week
Subsidized Employment – A participant who enters full-time or part-time employment that is being fully or
partially funded for by someone other than the employer.
22 Employment Type
23 Job Code/Title
Unsubsidized Employment – A participant who enters full-time or part-time employment that is being fully funded
by the employer.
Use the job code that best describes the individual’s type of employment. Record the SOC code that best describes
the individual’s type of employment as well as the title of the job. The job code will auto-fill the Job Title field.
Detail Screen Fields – Supportive Service Activities
- The following fields appear only if Supportive Services activities are selected.
24 Supportive
Services Type
25 Program Cost
26 Actual Cost
Select the type of supportive service that is being provided to the client.
Enter the total dollar amount of the cost to the provider for the supportive service to the client. This dollar amount
should reflect the amount of money that is being charged to the program. If there is no cost to the program/provider,
enter a dollar amount of $1.00.
Enter the total dollar amount associated with the cost of the provision of the supportive service to the client as it
pertains to the total dollar amount the client received. This is the dollar value of the service, not the cost to the
program/provider. This amount can differ from what was charged to the program. For example, a $25 gift
certificate may have been donated to the program, in which case the Program Cost would be 0 (enter $1), but the
Actual Cost would be $25.
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May 2010
Activity Codes and Definitions
Core A Activity Codes
Core A activities are self-directed activities. They are described as informational only with no significant staff
involvement on an individual basis. Case Notes are also included as Core A activities. See the Introduction to this
chapter for more discussion of Case Notes.
A list of Core A activities, as existed at the time this Handbook was published, is listed below. This list changes
occasionally as additional activities are added.
All Core A Activities are one day activities. The end date will auto fill to match the begin date.
Core A activities are not viewed as services and do not keep registered clients active.
A/G
ABE/GED Assessment
AGL
ABE/GED Lab
AA
Assessment Appointment
AFA
Assistance with Financial Aid
CJW
CalJOBS and SanDiegoAtWork
CLO
Computer Lab Orientation
ESL
ESL Training
IAS
Initial/Self Assessment
ITA
ITA Research
ITP
ITA Pending
ITV
ITA Approved
JFY
Job Fair – Youth only
LMF
Labor Market Information
901
RRO
Orientation
Receive Referral to Core B/Intensive
Services
Resource Room Orientation/Usage
TT
Typing Test
PPA
VET Only Core A Pre-Program Assessment
603
Case Note
Activities
CN01
VET Only – Job Search Assistance
920
Assessment
CN11
Placement
CN02
Certification
CN12
Referral
CN03
Co-Enrollment
CN13
Second Review
CN04
Enrollment
CN14
Supportive Services
CN05
Exit
CN15
TRA
Follow-up
CN16
Training
CN07
ITA
CN17
Appointment
CN08
Intensive Assessment
CN18
Goal
CN09
Job Search
CN99
Other
CN10
Non-WIA Training
CN06
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May 2010
Core B Activity
Codes
Adult and Dislocated Worker
A Core B Service must be provided before a client can receive either Intensive or Training Activities. All Core B
Activities are one day activities. The end date will auto fill to match the begin date.
Code 100 = Followup Services,
Counseling
Use this activity for One-Stop and Adult provider clients who are placed, but not yet exited, to assist with retention
services, and for clients who are in training services to keep track of their status and needs.
Examples include telephone calls, e-mails or other correspondence that discuss the clients’ satisfaction with their job
or training, other employment retention or training issues or concerns that may impede their success, and/or the need
for other services. (Note: Other Core and Intensive Services may also be provided to clients who are placed and
clients who are in training.)
Follow-up services must be available for a minimum of 12 months after employment begins for registered Adults
and Dislocated Workers who are placed into unsubsidized employment. It includes comprehensive guidance and
counseling, which may include drug and alcohol abuse counseling and referral, as appropriate. Local areas have
broad discretion in determining the intensity and type of follow-up services.
Code 102 = Waive
Required Core B
Services
When determined necessary, the Center Manager may waive the requirement that Core B services be provided
before Intensive Services.
Code 110 = Staff
Assisted Job
Development
Staff assists the individual by working with the employer and job seeker.
Use this activity when an employer is contacted on behalf of a specific job seeker. Examples include “selling” a
client’s skills to a prospective employer, exploring job openings with an employer for a specific client, sending a
client’s resume to an employer for a specific listing, and/or as part of the negotiations with an employer for an OJT
for a specific client.
Code 120 = Staff
Assisted Job
Referrals
Staff refers the individual to an employment opportunity and assists with testing and background checks. Use this
activity when staff provide customized job leads, employment opportunities, Job Fair information, filling out job
applications, and/or help with determining specific employment requirements.
Code 130 = Staff
Assisted Job Search,
Placement
This activity may be used at each instance when assisting an individual job seeker in a one-to-one setting..
Activities may include:
Resume writing
Interviewing skills
Labor market guidance
Telephone techniques
Information on job openings
Job acquisition strategies
It includes the provision of office space and supplies for the job search with job search techniques, to include where
to look and how to look for employment, customized resume review, customized interview techniques, and/or
follow-up procedures.
This activity may be used when staff determines that more intensive services are required to obtain employment.
Additionally, this may be used when placement information is received and entered.
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May 2010
Code 140 = Staff
Assisted Workshops/
Job Clubs
Use this activity when a client attends any workshop that is specifically designed for and attended by
registered clients. ONLY registered participants may attend Core B Workshops.
Job search assistance (including job search skill training and job club activities) means the provision of instruction
and support to a participant to give the participant skills in acquiring full time employment. This is a one day
activity, the end date will auto-fill to match the begin date. The services provided may include, but are not limited
to:
•
Resume writing,
•
Interviewing skills,
•
Labor market guidance,
•
Telephone techniques,
•
Information on job openings,
•
Job acquisition strategies,
•
CalJOBS Workshop,
•
The provision of office space and supplies for the job search
Core B / Staff Assisted Workshops are specifically designed for and attended by registered clients only. They
are customized to the individual participant and may require follow-up assistance beyond the classroom. For
instance, a Core B Workshop may teach and review resumes, interviewing, job search strategies, in order to
further assist in developing an employment plan. Participants may receive more intensive and individualized help
and critiques of their resumes and other job search skills.
Code 150 = Other
Core Services
Code 160 = Non-WIA
Funded Core Services
Use this activity for other Core B services that do not fit into the above categories. Please clearly describe what
other Core B services were provided in the case note that supports the use of this code.
Core services were provided to the individual by Non-WIA funding sources.
Use this activity to identify Core B services provided to clients by other partners or agencies not funded under
WIA. (Note: Partners are encouraged to enter these activities into CISRS, if they do not this will have to be
determined and entered by WIA staff. This activity will most likely be determined by a follow-up on a referral.)
If one of the Core B Services (Codes 10-16) are provided using Non-WIA funds, please include the corresponding
activity code in the case notes that support this activity.
For example, a U.S. Veteran client registered under the Adult Program (Grant Code 201) is given a job lead by a
Veterans Representative not paid from WIA funds. In CISRS the activity would be documented as a “Code 16”,
and the case note corresponding to the activity would list “Veteran Representative Provided Job Lead for Client
John Doe. If a WIA funded position had been used, the activity would be listed as a Code 11”.
Code 18 = Local
Office Orientation/
IAW
Local Office Orientation is usually provided during the Initial Assessment Workshop (IAW). The IAW is a
component of the Worker Profiling and Reemployment Services (WPRS) system. The IAW provides job seekers
with a local office orientation and information on CalJOBS, the local labor market, and local employment and
training resources.
Code 19 = Job Fair
Information
Information provided about a structured, one-stop forum with a large number of employers, and job seekers that
links employers with a pool of qualified applicants to fill their job needs.
Code 21 = Staff
Assisted Initial
Assessment
An initial assessment (ProveIt! and/or Career Zone) was provided to the customer.
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May 2010
Intensive Activity
Codes
Please choose from the following Intensive Activity Codes to indicate any services or activities that the
participant may have received. All Intensive Activities are one-day activities, unless otherwise noted. The end
date will auto fill to match the begin date.
Code 245 = Waived
Required Intensive
Services
When determined necessary, the Center Manager may waive the requirement that Intensive services be provided
before Training Services.
Code 300 = Case
Management for
Participants
Case Management refers to the provision of a client-centered approach in the delivery of services. All
Intensive clients MUST be entered into this activity. Case Management refers to an all-encompassing, clientfocused delivery of customized services. This activity is a generalized activity used to place a client into
Intensive Services. All the specific services traditionally associated with case management are included in all
other Core B and Intensive Activities. Case Management assists in the coordination of specific Core B and
Intensive activities.
As with all services, Case Management MUST have a reciprocal response from the customer. Leaving a
message, mailing a letter, or e-mailing a customer is NOT an activity unless the customer returns the call,
or responds to the letter or e-mail, or visits the center and acknowledges the correspondence. See more
discussion on the definition of service in the introduction to this chapter.
Code 310 =
Comprehensive
Assessments
Comprehensive Assessment is a procedure designed to comprehensively assess the skills, abilities, and interests
of each employment and training participant using diagnostic testing and other assessment tools. This service is
provided as a staff assisted activity. This code should not be used for the use of self-assessment tools or
activities. The methods used in conducting the objective assessment may include:
•
Structured in-depth Interviews
•
Skills and aptitude assessments
•
Performance Assessments (for example, skills and work samples, including those that measure interest
and capability to train in nontraditional employment)
•
Interest or attitude inventories
•
Career guidance instruments
•
Aptitude tests
•
Basic skills tests
Assessment Services (Vet) – This assessment service is conducted after the initial needs based screening and is
intended to determine if the veteran is in need on one-on-one veteran’s case management services.
Code 320 =
Development of
Individual
Employment Plan
Use this code in the development of a plan to identify the employment goals, appropriate achievement objectives,
and appropriate combination of services for the participant to achieve their employment goals. The IEP
(Individual Employment Plan) is a living document and MUST be updated as needed and this code will be used
to show that service. Updates for this activity may include further discussions of employment strategies, training
options and training information, barriers to employment, and the Supportive Services or other services needed to
overcome the barriers.
Employment Development Plan (Vet) – A plan developed jointly by bye DVOP (VESS) and the LVER (VWS)
with specific goals for the client to achieve and the steps for reaching those goals.
Code 330 = Group
Counseling
Use this code to record group counseling and career planning services provided to the client to achieve their
employment goals. Use this activity only when a client attends a Group Counseling session facilitated by a Career
Counselor.
Code 340 =
Work/Entry
Employment
Experience
This activity is a planned, structured learning experience that takes place in a workplace for a limited period of
time. This is an open activity in which the provider must indicate a begin date and an estimated end date, or
actual end date, in order for the activity to be complete. This may be paid or unpaid and may take place in the
private for profit sector, the non-profit sector, or the public sector. This activity must be developed and
monitored by staff.
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May 2010
Code 350 = Individual
Counseling and
Career Planning
Use this code to record individual counseling and career planning services provided to the client to achieve
employment goals. Career Counselors and Workforce Advisors use this activity for counseling sessions based on
the results of an assessment when interviewing a client without an assessment tool or when using an assessment
from another source.
This code should not be used for leaving telephone messages, updating an IEP, or referring a client to a
workshop.
Code 360 = Out-ofArea Job Search
Use this activity when a client is provided services to conduct an out-of-area job search that goes beyond the
normal Core B job search activities. An example of this activity includes intensive assistance in determining
LMI in a particular area, researching housing and cost of living information, travel plans, community services and
job search assistance available in a particular area.
Code 370 = Relocation
Expenses
This code is no longer in use.
The Relocation Expenses Code may be used only for participants registered in the Career Advancement Center
Grant Code (CAC) and must be used in conjunction with activity code 81 (supportive services). This code may
be used for relocation expenses of Department of Defense eligible participants.
Code 380 = Short
Term Pre-vocational
Services
This activity identifies the development of learning skills, communication skills, interviewing skills, punctuality,
personal maintenance skills, and professional conduct, to prepare clients for unsubsidized employment or training.
Code 390 =
Internships
This activity identifies an internship that is referred, developed, or monitored by WIA funded staff.
Code 40 = Other
Intensive Services
Other intensive services that do not fit into the above categories. Please clearly describe what other intensive
services were provided in the case note that supports the use of this code. Currently, only Veterans programs
may use this code to show the provisions of the necessary tools or fees required to assist in the completion of
training and/or for placement and retention.
Code 41 = Non-WIA
funded Intensive
Services
If one of the Intensive Services are provided using Non-WIA funds, please include the corresponding activity
code in the case notes that support this activity.
This is an open activity in which the provider must indicate a begin date and an estimated end date, or actual end
date, in order for the activity to be complete.
For example, a U.S. Veteran Client registered under the Adult Program (Grant Code 201) and is placed in an
Internship by a Veterans Representative not paid from WIA funds. In CISRS the activity would be documented
as a “Code 41”, and the case note corresponding to the activity would list “Veteran Representative placed Client
John Doe in an Internship at XYZ Corp. If WIA funds were used the activity would be listed as a Code 39”.
Code 43 = Order
Search (Vet)
Use this activity code to document when LVER (VWS) or WIA staff performs an order search to identify job
seekers who meet the criteria of a job order. When conducting an order search resumes of veterans appear first on
a list, according to their veteran status. Non veterans cannot be referred to a new job order within the first 24
hours.
Code 44 = Bonding
Assistance
One-time fidelity bond covered, administered, and funded by EDD that protects employers from employees who
commit on-the-job theft or dishonest acts.
Code 45 = WOTC
Eligible (conditional
certification)
A Conditional Certificate (CC) can be issued to clients who fall within specific targeted groups. This CC can be
used as a marketing tool to encourage employers to hire job seekers within a targeted group who have barriers to
employment. Employers who hire these individuals may receive a tax credit by doing so.
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May 2010
Training Codes
Please choose from the following Training Codes to indicate any training services that the participant may have
received.
All Training Activity codes are open activities in which the provider must indicate a begin date and an estimated
end date, or actual end date, in order for the activity to be complete.
Code 50 = Adult
Education
This service must be offered in combination with other allowable training services (not including customized
training). For detailed local tracking of the delivery of training activities, Code 50 should only be used if the
Adult Education activities are paid for out of WIA funds. If the training was paid for with non-WIA funds,
use activity code “Non-WIA Funded Training Services” (Code 60), and indicate that the training provided was
“Adult Education” in the supporting Case Note.
State/Local Education (Vet) – This activity code will be used when the veteran is referred to the Regional
Occupations Program, Community Colleges, Universities, and State Colleges.
Code 51 = Customized
Training
This activity must be funded by WIA, approved by the local WIB and is:
•
Designed to meet the special requirements of an employer (including a group of employers);
•
Conducted with a commitment by the employer to employ an individual on successful completion of
the training; AND
•
For which the employer pays for not less than 50 percent of the cost of the training.
Code 52 =
Entrepreneurial
Training
Entrepreneurial training is provided to the client. This activity identifies an approved program of training
provided to clients who wish to start their own businesses. Code 52 should only be used if the
Entrepreneurial Training activities are paid for out of WIA funds. If the training was paid for with non-WIA
funds, use activity code “Non-WIA Funded Training Services” (Code 60), and indicate that the training provided
was “Entrepreneurial Training” in the supporting case note.
Code 53 = Job
Readiness Training
Training in job seeking and interviewing skills, understanding employer expectations, and enhancing a client’s
capacity to move toward self-sufficiency. This activity may be used to identify clients engaged in the Work
Readiness Certificate program and are working toward completion of a Work Readiness Certificate. The begin
date of this activity is the date when the client begins the Work Readiness Assessment process, or Work
Readiness Training.
Code 54 =
Occupational Skills
Training
Occupational skills training, including training for nontraditional employment.
Use this activity to identify Individual Training Account (ITA) occupational skills training. (Note: An additional
entry must be made on the Enrollment Form in the Date ITA Established field and the Total Amount of ITA field.)
Code 55 = On-the-Job
Training
This activity identifies training provided by an employer to a paid participant engaged in productive work in a job
that:
•
Provides knowledge or skills essential to the full and adequate performance of the job; and
•
Provides WIA funded reimbursement to the employer of up to 50 percent of the wage rate of the
participant, for the extraordinary costs of providing the training and additional supervision related to the
training; and
Is limited in duration that is appropriate to the occupation for which the participant is being trained, taking into
account the content of the training, taking into account the prior work experience of the participant, and the IEP of
the participant, as appropriate.
Code 56 = Private
Sector Training
Training programs operated by the private sector. This Code is currently not used.
Code 57 = Skill
Upgrading and
Retraining
Training provided for the purpose of upgrading the skills and/or retraining the client. Currently not often used
by the Career Center Network and Adult providers. (An example of when this code might be used would be if
a client had exhausted their ITA, and were referred to a contracted training provider in the pursuit of life long
learning and to further develop their marketable job skills.)
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May 2010
Code 58 = Workplace
Training /Cooperative
Education
Programs that combine workplace training with related instruction, which may include cooperative education
programs. Adult providers may use this code. This Code is currently not used by the Career Center Network.
Code 59 = Other
Training Services
Other training services that do not fit into the above categories. Adult providers must use this code when training
services are contracted with a training provider not on the ETPL. This Code is currently not used by the Career
Center Network.
Code 60 = Non-WIA
Funded Training
Services
This activity identifies any vocational or occupational training provided to an individual by any source not funded
by WIA. Examples include:
Code 62 = Remedial
Training
Use this activity to document when remedial training services are provided to the client.
Code 63 = Institution
of Higher Education
Training
Institutions of Higher Education (IHE) funded training.
Use this activity to identify Institution of Higher Education training. IHE grant training programs are not listed
on the ETPL.
Veterans Program
Activity Codes
These codes are to be used by Veterans Programs only. All Veterans Program Activities are one day activities,
unless otherwise noted. The end date will auto fill to match the begin date.
64 = Vet Only –
Disabled Veterans’
Outreach
Program (DVOP)
This activity is used only by Veterans’ Service Providers. This activity may be used to document services
provided to veterans with an emphasis on veterans with service-connected disabilities.
65 = Vet Only –
Local Veteran’s
Employment
Representative
(LVER)
This activity is used by Veterans’ Service Providers. This activity is used to document services provided to
veterans through local employment offices.
600=Vet Only –
Literacy/Bilingual
Training
This activity is used only by Veterans’ Service Providers. This activity may be used to show training in Literacy
and/or Bilingual skills for veterans whose inability to speak, read, or write English or to effectively reason
mathematically, constitutes a substantial impairment to their ability to get or retain employment.
601=Vet Only –
Institutionalized
Skills Training
This activity is used only by Veterans’ Service Providers. This activity may be used to show training for veterans
conducted in an institutionalized setting designed to ensure that individuals acquire the skills, knowledge, and
abilities necessary to perform a job or group of jobs in an occupation for which there is a demand.
•
•
•
•
•
•
•
•
Vocational Rehabilitation
Scholarships
ROP
Pell Grants
ETP
Community College and Universities
Personal Funds
GI Bill
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May 2010
602=Vet Only –
Apprenticeship
Training
This activity is used only by Veterans’ Service Providers. This activity may be used for veterans receiving formal
occupational training program which combines on-the-job training and related instruction in which workers learn
the practical and conceptual skills required for a skilled occupation, craft, or trade.
604=Vet Only –
Tools/Fees
Youth Activity Codes
(700 Series)
This activity is used only by Veterans’ Service Providers. This activity may be used to show the supportive
services for tools and fees to assist an enrolled veteran in job search. It must be used in conjunction with Code
81.
These codes are to be used by WIA Youth Providers for In-School and Out-of-School Youth Programs only.
Providers are required to only use these codes, Core A codes, and codes 83 and 86 (Planned Break in
Service). For referrals to any collaborative partner or other agency/program, please use the Referral
Form.
The number of days of duration allowed for each Youth Activity Code varies from 1-day to 30-day activities. For
those activities that are 1-day activities, the Estimated End Date will auto fill to 1 day after the Begin Date. For
those activities that are 30-day activities, the Estimated End Date will auto fill to 30 days after the Begin Date.
Users should update the actual End Date to the appropriate date once the activity ends or the 30 days has expired.
All services MUST have a reciprocal response from the customer. Leaving a message, mailing a letter, or emailing a customer is NOT an activity unless the customer returns the call, or responds to the letter or email, or visits the center and acknowledges the correspondence.
In some cases, services are provided to the customer by an outside service provider (not the Workforce
Partnership contracted service provider). For example, a customer may receive substance abuse counseling from
an independent provider. As long as the service is coordinated and verified by the contracted service provider as
part of the customer’s WIA services, that service can and should be recorded in the customer’s Service Record.
The information on this service may come directly from the customer, or from the outside service provider (in the
example above, the counselor). The date that should be entered into CISRS for the service, is the date when the
service was actually provided, not the date of the contact with the outside service provider.
Occasionally, a case manager may learn from a customer’s parent, spouse, teacher, or other contact, that the
customer has received a service from an outside service provider (other than the contracted service provider).
That service must be verified by either the customer, or directly by the service provider that provided the service.
A service reported by the parent, spouse or other contact should not be recorded on the customer’s Service Record
until it is verified by the customer or the actual service provider. However, the contact with the parent, spouse,
etc, should be recorded as a Case Note.
700=Summer Work
Experience
Use this code when youth participate in paid and unpaid work experience, including internships, during the
months of June through August. Summer Work Experience is intended for summer specific employment. If the
youth is engaged in work experience that lasts longer than the summer months, use Work Experience (Code 721).
710=Alternative
Secondary School
Use this code for Youth placed in Alternative Secondary School services. An Alternative Secondary School is
defined as a non-standard high school, other than a home school, for students with special needs, interests, or
learning styles. The date of service is the first day it can be verified the youth is attending/participating in the
secondary school.
711=Tutoring
Use this code when youth participate in activities to enhance study skills, educational guidance, and instruction
leading to completion of secondary or postsecondary school. Tutoring examples include individual or group
academic support services. This service may be provided either in or out of a school setting.
712=Preparation for
Postsecondary
Education
Use this code when youth participate in activities that prepare them for postsecondary educational opportunities.
Examples include SAT Preparation, college preparation courses, courses leading to a participant’s entry into
postsecondary education, assistance with college applications and entrance letters, assistance with financial aid,
college tours, orientations, and college fairs.
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May 2010
713=Postsecondary
Education
Use this code when youth participate in Postsecondary Education activities. Post secondary education is
considered a program at an accredited degree-granting institution that leads to an academic degree (e.g. AA, AS,
BA, BS). This does not include programs offered by degree-granting institutions that do not lead to an
academic degree, such as courses offered through university extension programs.
714=Basic Skills
This code only applies to Basic Skills Deficient Youth who participate in an activity to enhance Basic Skills
remediation. Basic Skills Deficient Youth are defined as an individual who has English reading, writing, or
computing skills at or below the 8th grade level (8.9) on a generally accepted standardized test or a comparable
score on a criterion-reference test, or;
Is unable to compute or solve problems, read, write, or speak English at a level necessary to function on the job,
in the individual’s family, or in society.
715 =GED
Preparation
Use this code when youth participate in a structured process of preparing participants in any of five (5) areas:
Math, English, Writing, Science and/or Social Studies in order for them to obtain a certificate of completion.
716=Incentives
Use this code to identify any Incentive activity received by a youth client, coming from WIA youth funds.
Incentives can be given out in accordance with the providing agency’s approved incentive policy.
Youth Incentives is a one time activity. Providing agency must document the amount of the incentive, what the
incentive was given for, and the form of the incentive, (check, gift card, admission ticket, etc.)
720=Occupational
Skills/Advanced
Training
Use this code when youth receive either Occupational Skills/Advanced Training or participate in an activity such
as any pre-apprenticeship training, ROP, or vocational training that is deemed preparation for a long-term
unsubsidized job or long-term educational or occupational skills.
721=Work Experience
Use this code when youth participate in paid and unpaid work experience, including internships, not including
summer work experience opportunities (see Summer Work Experience, Code 700, or Job Shadow, Code 724).
Work Experience is defined as a short-term and/or part-time work assignment with an employer or private nonprofit agency that is subsidized or unsubsidized and which provides an individual with the opportunity to acquire
the skills and knowledge necessary to perform a job, including appropriate work habits and behaviors, and is
combined with classroom or other training.
722=Work Readiness
Use this code when youth participate in a Work Readiness Skills Training/Activity. Work Readiness Skills
include world of work awareness, labor market knowledge, occupational information, values clarification and
personal understanding, career planning and decision-making, and job search techniques (resumes, applications,
interviews, and follow-up letters).
They also include Career Guidance Counseling, including techniques and strategies for career development,
including self-assessment, career exploration, and job search, positive work habits, attitudes, and behaviors such
as punctuality, regular attendance, presenting a neat appearance, getting along and working well with others,
exhibiting good conduct, following instructions and completing tasks, accepting constructive criticism from
supervisors and co-workers, showing initiative and reliability, and assuming the responsibilities involved in
maintaining a job. This category also entails developing motivation and adaptability, obtaining effective coping
and problem-solving skills, and acquiring an improved self image.
723=Job Placement
Services
Use this code when services are provided to assist a youth in obtaining a specific placement in unsubsidized
employment (see Code 130 for more description). Additionally, this may be used when placement information is
obtained and entered into CISRS. Reminder: When a youth is actually placed in unsubsidized employment, a
Placement Form must also be filled out.
724=Job Shadow
Use this code when youth participate in an unpaid short-term activity offered by an employer who agrees to
engage a student to follow or “shadow” them throughout their work day, providing insight on the duties and skills
of the position, and information on career tracks.
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May 2010
725= Preparation for
Occupational or
Vocational Education/
Training
Use this code when youth participate in activities that prepare them to enter into Occupational Skills Training or
other pre-apprenticeship training, ROP, or vocational training. The programs the youth is preparing to enter could
include either short-term or long-term training programs, apprenticeship programs, or even military programs
requiring an entrance exam. An example would include a youth who needs to take a prerequisite course (or
receive other educational assistance) to prepare them to enter a vocational training program, or take an entrance
exam to enter the program. It may also include any other activities that prepare youth for these programs,
including orientations, assistance with applications, assistance with financial aid, etc. This code should be used in
a similar manner to Prep for Postsecondary Education, except that it applies to training and education programs
that do not qualify as postsecondary education programs.
726 = Occupational
Skill Attainment
Use this code when a youth achieves an Occupation Skill.
Occupational Skills are those skills that are occupation specific. These skills are learned through on the job
training, pre-apprenticeship training, ROP, or vocational training.
There must be assessment methods in place to evaluate these skills and the Occupational Skill Attainment must be
documented in the ISS. There also must be documentation in the ISS of the way in which these skill attainments
were observed and evaluated.
727 = Work Readiness
Skill Attainment
Use this code when a youth achieves a Work Readiness Skill.
Work Readiness Skills are the foundation skills that are academic and behavioral characteristics necessary for
success in the world of work such as work maturity, employability, pre-employment, and occupational/technical
skills. Work Readiness Skills include world of work awareness, labor market knowledge, occupational
information, values clarification and personal understanding, career planning and decision-making, and job search
techniques (resumes, applications, interviews, and follow-up letters).
There must be assessment methods in place to evaluate these soft-skills, and Work Readiness Skill Attainments
must be documented in the ISS. There also must be documentation in the ISS of the way in which these skill
attainments were observed and evaluated.
728 =WAY Internship
Use this code when a youth participates in the Workforce Academy for Youth internship program, sponsored by
the County of San Diego.
730=Leadership
Development
Use this code when youth participate in activities to encourage responsibility, employability, and other positive
social behaviors such as:
•
Exposure to postsecondary educational opportunities;
•
Peer-centered activities, including peer mentoring and tutoring;
•
Organizational and team work training, including team leadership training;
•
Training in decision-making, including determining priorities; and
•
Citizenship training, including life skills training such as parenting.
731=Mentoring by
Peers
Use this code when youth participate in activities where a more experienced youth participant serves as a type of
advisor or role model to a less experienced participant. Mentoring is on a 1-to-1 basis, establishing a supportive
relationship, providing academic assistance, and introducing the youth to new experiences that enhance the
youth's ability to excel in school or employment and become a responsible citizen.
732=Community
Service
Use this code when youth are involved in projects intended to benefit the community. Community Service
projects may be short or long term, but should integrate service with instruction that enriches learning, teaches
civic responsibility, improves work readiness skills, and strengthens the surrounding community.
740=Assessment
Use this code when youth participate with staff in either a Pre or Post Assessment activity. An assessment is
defined as an independent comprehensive evaluation of an individual to identify skills, abilities, aptitudes and
interest used to design a service strategy and/or baccalaureate degree.
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741=Mentoring by
Adults
Use this code when youth participate in activities where an adult serves as a type of advisor or role model.
Mentoring is on a 1-to-1 basis, establishing a supportive relationship, providing academic assistance, and
introducing the youth to new experiences that enhance the youth's ability to excel in school or employment and
become a responsible citizen.
742=Comprehensive
Substance Abuse
and/or Psychological
Counseling
Use this code when youth participate in licensed, credentialed, or clinical substance abuse and/or psychological
counseling. Counseling may be one to one, or in a group setting. Counseling and treatment plans may include a
12-step program, or other commonly accepted substance abuse and psychological counseling practices.
743=High School
Certificate of
Completion
Use this code to record the attainment of a High School Certificate of Completion, in place of a high school
diploma. Note, this is not a performance measure and is a tracking measure only.
744=Computer
Literacy Skills
Use this code for youth who participate in computer training, computer skill development workshops, or training
that provides skills leading to computer literacy.
745=Life Skills
Activities
Life Skills Activities include activities that prepare youth for independent living. Activities may develop skills in
legal issues, housing, personal finance, health and nutrition, employment, personal relationships, and change
management. They also encompass survival/daily living skills such as using the phone, telling time, shopping,
renting an apartment, opening a bank account, and using public transportation.
746=Development of
the ISS
Use this code in the development of a plan to identify the participant’s education and employment goals. The ISS
is a living document and MUST be updated as needed. This code will be used to show that service. Updates for
this activity may include further discussions of education and employment strategies, training options, and
training information, barriers education and/or employment, and the Supportive Services or other services needed
to overcome the barriers.
747=Case
Management Services
Case Management refers to the provision of a client-centered approach in the delivery of all-encompassing,
customized services. This is an activity used to document the general coordination of all other youth services
(700 series codes).
As with all services, Case Management MUST have a reciprocal response from the customer. Leaving a
message, mailing a letter, or e-mailing a customer is NOT an activity unless the customer returns the call,
or responds to the letter or e-mail, or visits the center and acknowledges the correspondence. See more
discussion on the definition of a service in the introduction to this chapter, or in the description of the Youth
Services codes at the beginning of this section on the 700 series.
748=High School
Diploma Attainment
Use this code to record the attainment of a High School Diploma prior to exit. Note, that at exit, in order to
receive credit for the diploma attainment performance measure, diploma attainment MUST be documented on the
exit form.
749=GED Attainment
Use this code to record the attainment of a GED prior to exit. Note, that at exit, in order to receive credit for the
GED performance measure, GED attainment MUST be documented on the exit form.
750=Other Degree or
Certificate Attainment
Use this code to record the attainment of a degree or certificate prior to exit*. Note, that at exit, in order to
receive credit for the certificate attainment performance measure, certificate attainment MUST be documented on
the exit form.
* A certificate is awarded in recognition of an individual’s attainment of measurable technical or occupational
skills necessary to gain employment or advance within an occupation. These technical or occupational skills are
based on standards developed or endorsed by employers. Certificates will include but are not limited to a high
school diploma, GED, or other recognized equivalents, postsecondary, recognized skills standards and licensure
or industry recognized certificates. States should include all State Education Agency recognized credentials.
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Certificates awarded by workforce investment boards are not included in this definition. Work readiness
certificates are also not included in this definition.
751=Financial
Literacy
752=Other Youth
Development
Activities
753=Return to
Secondary School
754=Grade Level
Advancement
Activities enhancing the participant’s ability to make informed judgments and to make effective decisions
regarding the use and management of money. Examples include balancing a checkbook, budgeting, and filing a
tax return.
These include other positive and engaging youth activities, such as arts, cultural, civic, athletic or recreational
type programs, provided in a group, peer-to-peer or individualized setting.
Use this code when a participant enrolled as an out-of-school youth returns to a secondary school institution. This
is a one-time activity code.
This achievement may be recorded for youth who advance to the next grade level in school. For example,
Sophomore to Junior in high school.
This activity code is intended for use by the current gang-prevention programs, who serve ex-offenders as well
youth at risk of gang participation and/or offending. The intention is for these programs to be able to better
demonstrate some of the youths’ accomplishments prior to attainment of some of the longer term performance
measures.
755=GPA Increase
This achievement may be recorded for youth who show an increase in Grade Point Average (GPA) at the end of
the most recent semester compared to the previous semester (or comparable reporting period, i.e. trimester).
measures.
756=Satisfactory
School Attendance
This achievement may be recorded for youth who have missed no more that 10 days of school in the most recent
semester (or comparable reporting period, i.e. trimester).
measures.
757=Justice System
Aversion (6 months)
This achievement may be recorded for youth who have had no official engagement in the justice system for the
previous 6 months. This applies both to youth participating in a prevention program who are at risk of offending
but have no history of incarceration, as well as those who have previous offenses and are at risk of recidivism. It
applies to both gang and non-gang-related offenses. Official engagement in the justice system is defined as
having a new legal charge, going back on probation, going back to juvenile hall or to another penal institution,
and/or, having new charges added to an existing charge.
measures.
760=Supportive
Services
Use this code to identify any supportive service activity received by a youth client. Supportive Services are
intended to help a client remain active in activities outlined in WIA Title I Programs. Supportive Services may
include assistance with transportation, childcare, dependent care, housing, and needs-related payments, which are
necessary to enable an individual to participate in activities authorized under Title I of WIA. See Supportive
Services Policy for more clarification.
For referrals to supportive services or other agencies or programs, please see the Referral Form.
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Youth Supportive Services is an open activity in which the provider must indicate a begin date and an estimated
end date, or actual end date, in order for the activity to be complete.
770=Pre-Exit Follow
Up Services
These types of activities include but are not limited to workshops, phone calls, activities, and training BEFORE
the youth has exited. Pre-Exit Follow-Up Services assist with retention services, and for youth who are in training
services, to keep track of their status and needs. Examples include telephone calls, e-mails or other interactive
exchanges with the youth that discuss the youth’s satisfaction with their job or training, other employment
retention or training issues or concerns that may impede their success, and/or the need for other services.
Post Exit Youth Codes
(800 Series)
These codes are to be used exclusively for the recording of post-exit follow-up service activities. The ‘800’ series
codes correspond directly to the ‘700’ series code services provided while youth are actively enrolled in relation
to the definition. EXAMPLE: Code 760=Supportive Services (active participants only) Code 860=Supportive
Services (follow-up participants only). There are a few exceptions to this, where there is not a corresponding Post
Exit Activity. These exceptions include: Summer Work Experience, Work Experience, Development of the ISS,
High School Diploma Attainment, GED Attainment, Other Credential Attainment, Work Readiness Skill
Attainment, Occupational Skill Attainment, and Pre-Exit Follow-up Services.
Miscellaneous Activity
Codes
All Miscellaneous Activities are one-day activities, unless otherwise noted. The end date will auto fill to match
the begin date.
Code 80 = Other
JTPA
This Code is no longer used. Other miscellaneous activities that were allowable under JTPA but are not
allowable under WIA. This code was used as a “placeholder” for clients that rolled over into WIA from JTPA.
Code 80 waived the Core B and Intensive Services requirements from the client flow under WIA.
Code 81 = Supportive
Services
This code is ONLY used by the currently contracted provider for Supportive Services. Supportive Services
are intended to help a client remain active in activities outlined in WIA Title I Programs. Supportive Services
may include assistance with transportation, childcare, dependent care, housing, and needs-related payments,
which are necessary to enable an individual to participate in activities, authorized under Title I of WIA.
Code 82 = NeedsRelated Payments
The Career Center Network no longer uses this Code.
Adults/Dislocated Workers in Training Services - Funds allocated to a local area that may be used to provide
needs-related payments to adults and dislocated workers, respectively, who are unemployed and do not qualify for
(or have ceased to qualify for) unemployment compensation for the purpose of enabling such individuals to
participate in programs of training services.
Additional Eligibility Requirements - A dislocated worker who has ceased to qualify for unemployment
compensation may be eligible to receive needs-related payments only if such worker was enrolled in the training
services by the end of the 13th week after the most recent layoff that resulted in a determination of the worker's
eligibility for employment and training activities for dislocated workers under this subtitle; or
If later, by the end of the 8th week after the worker is informed that a short-term layoff will exceed six-months.
Also, the individual did not qualify for or must or have ceased to qualify for unemployment compensation or trade
adjustment assistance under TAA or NAFTA-TAA in order to be eligible to receive needs-related payments.
Code 83 = Planned
Break in Service:
Delay in Training
Use this activity code to identify participants who have a planned gap in service of greater than 90 days, due to a
delay before training that prevents an individual from participating in services. (See Code 86 below for Planned
Break in Service for other reasons.)
Use of this code will prevent a soft exit for a client. Service providers must clearly document any gap in service
that occurs with a reason for such a gap in service. Otherwise, once a participant has not received any WIA
funded or partner services for 90 days or more they must be exited from the system (considered a “soft exit”).
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Code 84 = Non-WIA
Funded Miscellaneous
Only Adult providers may use this code to show services from other grants for those clients co-enrolled.
Code 86 = Planned
Break in Service:
Health/Medical
Use this activity code to identify participants who have a planned gap in service of greater than 90 days, due to a
health or medical condition or a short-term incarceration that prevents an individual from participating in services.
(See Code 83 above for Planned Break in Service due to a delay in training.)
Use of this code will prevent a soft exit for a client. This condition must be for the individual participant only.
This code MAY NOT be used for the care of a spouse, family member, or significant other.
This could include pregnancy related health problems that preclude participation in training educational or
employment related activities.
Service providers must clearly document any gap in service that occurs with a reason for such a gap in service.
Otherwise, once a participant has not received any WIA funded or partner services for 90 days or more they must
be exited from the system (considered a “soft exit”).
Code 93 = Referral to
Supportive Services
Provider
This activity identifies a referral to the currently contracted Supportive Services Provider for Supportive Services.
This code should be used every time a referral is made for supportive services. (Note: This activity code cannot
be accessed through the Enrollment/Activity Form. It is only added to a customer’s service record when a
Referral Form is completed for a participant. A referral should be used every time a referral is made for
supportive services).
Code 94 = Referral to
Other Agency
This activity identifies a referral to any mandatory partner, optional partner, or other agency. This referral is for
services other than the Supportive Services from the current contracted providers. Note: (This activity code
cannot be accessed through the Enrollment/Activity Form. It is only added to a customer’s service record when a
Referral Form is completed for a participant. A referral should be used every time a referral is made.)
Code 95 = Non-WIA
Funded Supportive
Services
This code is ONLY used by the currently contracted provider for Supportive Services. Costs of in-kind
supportive services shall be documented as “actual cost” by the Supportive Service Provider.
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Chapter 8
IEP Form
The Individual Employment Plan (IEP), or the Employment Development Plan (EDP) for
some Adult providers, serves as the basis for the entire case management strategy for all
participants in Intensive Services. It is jointly developed by the participant and case manager
and must be regularly reviewed and adjusted to reflect the progress and meet the continuing
needs of the participant. It identifies the participant’s employment goals, the appropriate
achievement objectives, and the appropriate combination of services for the participant to
achieve the employment goals.
An IEP must be developed for each WIA Adult and Dislocated Worker registered in
Intensive Services based upon information obtained during in-depth comprehensive
assessment and/or during case management sessions. The IEP shall be created and
continuously updated using CISRS. Activity Code 320 (Development of IEP) identifies this
activity in the participant’s Service Record and on the Checklist.
The IEP is the instrument used to document decisions made regarding the mix and sequence
of services for each participant, including referrals to other programs. Additionally, it
provides justification and/or amplification for Supportive Services and, if applicable, the
implementation of an Individual Training Account (ITA) or for training services paid for
with WIA funds such as OJT or contracted training services. The IEP should include
background information, barriers to employment, assessment results and summary (as
applicable), employment plan, and referral services.
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1
2
3
4
5
6
7
8
9
10
11
12
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15
14
16
17
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18
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19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
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37
38
39
40
41
42
43
44
45
46
47
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Background Information
NOTE: Some information on the Background Information form is displayed as it appears on the WIA Application
form, and cannot be edited on this form. These fields include Name, SSN, Birth date, Age, Address, Phone, Gender,
Highest Grade Completed and Education Status. Definitions for these fields can be found in the WIA Application
chapter.
1 Date
The date defaults to the current date the form is first accessed or updated. Subsequently, it keeps the first date the form
was saved but may be changed, if required. The date usually will be the first time a participant sits down with a staff
person and provides any information used in the IEP, including background information.
2 Agency
The system will default to the agency code associated with a staff person logged into the system.
3 High School
Diploma
Select “Yes” if the participant has obtained a high school diploma. Do not select yes for the obtainment of a GED.
4 Any Additional
Education or
Vocational
Training
Select “Yes” if the participant has any additional education or vocational training.
5 What Areas
Enter the kind of additional education or vocational training the participant has received and completed.
6 Any Additional
Diplomas/ Degree/
Certifications
Enter any diplomas, degrees, or certificates the participant has attained.
7 Diplomas/
Degrees/ Licenses
Enter any more diplomas, degrees, licenses, or certificates the participant has attained.
8 Additional
Education/
Vocational
Training taken
Enter the kind of additional education or vocational training the participant has received but has not completed.
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Employment History
9 Internal Job
Title
Select the job code that best describes the job title.
10 From Date/ To
Date
Select the month and year that the participant began employment and the month and year the participant’s employment
ended.
Describe the job duties and requirements of the participant’s job.
11 Job Duties
Describe the reason the participant left the job.
12 Reason for
Leaving
Barriers
13 Barrier Type
14 User
15 Barrier Code
Select the type of barrier(s) that the participant faces.
Select the staff who determined the participant’s barrier(s).
Select the code appropriate for the specific barrier within the type of barrier selected.
16 Barrier Name
The name of the barrier will fill automatically corresponding to the barrier code.
17 Open date
Select the date that the barrier was determined.
18 Notes
Describe the barrier(s) and the strategy and services that will be provided to overcome it.
Assessment Results
19 Reading Test/Score
If the participant was tested for reading proficiency, and a reading score was entered on the WIA Application,
select the name of the test that was used to determine that score. That score and the grade level will be
displayed on this form, as they were entered on the WIA Application.
Enter the date the reading test was administered to the participant.
20 Reading Test Date
21 Math Test/Score
22 Math Test Date
If the participant was tested for math proficiency, and a reading score was entered on the WIA Application,
select the name of the test that was used to determine that score. That score and the grade level will be
displayed on this form, as they were entered on the WIA Application.
Select the date the math test was administered to the participant.
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23 Other Proficiency
Test/Score and Date
If the participant was tested for other proficiencies using a generally accepted standardized or criterionreferenced test, select the name of the test. Enter the participant’s raw score, and the date the test was
administered to the participant
24 Interest Assessment
Method
If an interest inventory was administered to the participant, list method for determining the participant’s interest
inventory.
25 Interest Inventory
Test
If an interest inventory was administered to the participant using a generally accepted standardized or criterionreferenced interest inventory test, select the name of the test.
Test Date
Enter the date the interest inventory test was administered to the participant.
Describe the results of the test and give comments, if applicable.
Test Results/ Comments
28 Aptitude Inventory
Test
If an aptitude inventory was administered to the participant using a generally accepted standardized or
criterion-referenced aptitude inventory test, select the name of the test.
Test Date
Enter the date the aptitude inventory test was administered to the participant.
31 Transferable Skills
Test
Test Date
34 Additional Test
If a transferable skills inventory was administered to the participant using a generally accepted standardized or
criterion-referenced test, select the name of the test.
Enter the date the transferable skills inventory test was administered to the participant.
If any additional test was administered to the participant using a generally accepted standardized or criterionreferenced test, select the name of the test.
Enter the date the interest inventory test was administered to the participant.
35 Additional Test Date
36 Additional Test
Results/Comments
Assessment Summary
37 Assessment Date
Select the date of the assessment.
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38 Summary
Summarize the counseling session and/or, in-depth interview.
39 Assets and
Obstacles
Describe the assets that the participant possesses. Describe the obstacles that the participant may face in attaining
their educational and employment goals.
40 Recommendations
Describe possible strategies to overcome these obstacles. Describe the mix of services that may help the
participant achieve success such as training and/or supportive services.
41 Services to
Consider
Describe the specific services for the strategy that will assist the participant in achieving the educational and
employment goals.
42 Counselor
Select the counselor conducting the counseling session or in-depth interview.
43 Assessment Site
Enter the location the assessments took place.
Set Goals
44 Occupational/ Job
Code
Select the job code that best describes the job title that matches the participant employment goal.
45 Industry Code
Select the industry code that best describes the industry that matches the participant employment goal.
46 Job Ready Status
47 Notes
Select the status indicating whether the client is or is not job ready.
For those participants who are working towards a career in an occupation they are not yet skilled for, document
their educational strategy. If they are skilled in that field and are job ready, document their employment strategy.
Add the activities/services that may be provided in pursuit of this goal. Describe any barriers to this goal and any
actions, tasks, and/or services that may be taken to overcome those barriers.
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Chapter 9
WIA Youth Test Scores Form
Introduction and Form Purpose
The WIA Youth Test Scores Form is used to record the attainment of Literacy and/or
Numeracy skills by a WIA youth client. This information is to be used for
performance measurement as well as case management.
Effective immediately, mandatory completion of this form is required for all youth
participants who are basic skills deficient and classified as Out of School. Beginning
on July 1, 2007, it will also be required for Youth participants who are basic skills
deficient and classified as In School.
The form provides a place to record test results that quantify the youth’s initial skill
level (pre-test) and post-program skill level (post-test). To determine whether a youth
has gained an Educational Functioning Level (EFL), the EFLs at the pre-test and at
the post-test are compared. The fields on the form include:
1. ESL (English-As-A-Second Language, Yes or No)
2. Test Type
3. Functional Area
4. Test Score
5. Educational Functioning Level (EFL)
6. Date Administered
Literacy and Numeracy Gains Performance Measure Definition
The Common Measures definition of the Literacy and Numeracy Gains Performance
Measure:
Of those out-of-school youth who are basic skills deficient:
Number who increase one or more educational functioning levels
Number who completed a year of participation + Number who exit before completing
a year of participation
Test Types and Time Period
Programs must use one of the approved assessment tools (see list in item 2, Test
Type, in the table below or Attachment C of the Common Measures policy, TEGL
17-05). The same assessment tool must be used to administer the pre-test and the
post-test to an individual youth. Tests results from tests administered up to 6 months
prior to WIA Enrollment are allowable as the Pre-test. Otherwise, Pre-tests must be
administered within 60 days following WIA Enrollment.
The terms “pre-test” and “post-test” are not specifically noted on the form. However,
for purposes of the performance measurement, the pre-test is considered the test score
with the earliest administration date. The post-test is the test score with the latest
administration date, that is within 1 year of the youth’s enrollment date, or at the
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youth’s exit date (whichever comes first). Please note: the 1-year time period is from
the date of enrollment, not the date of the pre-test.
Functional Areas for Literacy and Numeracy Gains
Adult Basic Education
• Reading • Math
• Writing • Other
English-As-A-Second Language
• Reading & Writing
• Literacy
• Speaking
• Listening
• Oral
• Other
If a youth is deficient in more than one Functional Area, scores for multiple
Functional Areas may be recorded on this form.
Educational Functioning Levels
Educational Functioning Levels are determined using the Educational Functioning
Levels Descriptors table (see “Attachment C of the Common Measures Policy”,
TEGL 17-05). Once the youth’s Test Score is determined, the EFL Table should be
used to crosswalk the test score to the corresponding EFL.
Attainment of a Literacy or Numeracy Skill Gain is determined by comparing the
EFL of the first score for a given Functional Area to the EFL of the last score for that
Functional Area (within the 1 year time period, or at exit, whichever comes first).
Gains Requirements after First Year
Youth who remain basic skills deficient and continue to participate after completing a
full year in the program, must continue to receive basic skills remediation services.
They are only included in the measure again, if they complete a second full year in
the program. At the completion of the second year, these participants must be
included in the measure using the latest post-test score during the second year. To
determine an increase of one or more levels, the youth’s latest post-test score from the
second year in the program must be compared to the score from the test that was
administered at the latest point during the first year.
For more information on Literacy and Numeracy Gains measurement, testing, and
skill levels, please refer to the DOL Common Measures Policy (DOL TEGL 17-05),
and its Attachment C – Educational Functioning Level Descriptors.
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Ignore these – they are inaccurate and will be removed.
1
2
4
5
3
6
Pre-test
Post-test
Post-test
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1 ESL
Select the appropriate number.
1
Yes—Individual is a person who has limited ability in speaking, reading, writing or understanding the
English Language.
AND
a.
Whose native language is a language other than English
OR
b.
2
2 Test Type
Who lives in a family or community environment where a language other than English is the
dominant language.
No—Individual does not meet the condition described above.
Select the test type from the drop down list.
If ESL (Field 1) is No, select one of the following Adult Basic Education test types:
1.
Test Adult Basic Education 7 – 8 (TABE 7– 8)
2.
Test Adult Basic Education 9 – 10 (TABE 9–10)
3.
Comprehensive Adult Student Assessment System-LIFE (CASA-LIFE)
4.
Adult Basic Learning Exam (ABLE)
5.
Work Keys
6.
Other Approved Assessment Tools (Other Tools)
If ESL (Field 1) is Yes, select one of the following English-as-a-Second Language test types:
3 Functional Area
1.
Comprehensive Adult Student Assessment System—LIFE (CASA-LIFE)
2.
Student Performance Levels (SPL)
3.
Basic English Skills Test (BEST)
4.
Basic English Skills Test Plus (BEST Plus)
5.
Other Approved Assessment Tools (Other Tools)
Select the Functional Area from the drop down list.
If ESL (Field 1) is No, select one of the following Adult Basic Education functional areas:
1.
Reading Functional Area
2.
Writing Functional Area
3.
Language Functional Area
4.
Mathematics Functional Area
5.
Other Functional Area
If ESL (Field 1) is Yes, select one of the following English-as-a-Second Language functional areas:
1.
Reading and Writing Functional Area
2.
Speaking Functional Area
3.
Oral Functional Area
4.
Literacy Functional Area
5.
Listening Functional Area
6.
Other ESL Functional Area
Please Note: For each functional area for which a test score is recorded, the youth should be engaged in an
appropriate activity. Therefore, there should be service(s)/activity(ies) in the customer’s Service Log that
relates to the functional area.
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Record the client’s test score.
4 Test Score
5 Education Level
Select the Educational Functioning Level (EFL) from the drop down list.
Educational Functioning Levels are determined using the Educational Functioning Levels Descriptors table
(Attachment C of Common Measures Policy, TEGL 17-05,). Once the youth’s Test Score is determined, the
EFL Table should be used to crosswalk the test score to the corresponding EFL.
If ESL (Field 1) is No, select one of the following Adult Basic Education Levels:
1.
Beginning ABE Literacy (BGN ABELIT)
2.
Beginning Basic Education (BGN BASEDU)
3.
Low Intermediate Basic Education (LOW INT BE)
4.
High Intermediate Basic Education (HIGH INT BE)
5.
Low Adult Secondary Education (LOW AD SEC)
6.
High Adult Secondary Education (HIGH AD SEC)
If ESL (Field 1) is Yes, select one of the following English-as-a-Second Language Levels:
11
12
13
6 Date
Administered
1.
Beginning ESL Literacy (BGN ESLLIT)
2.
Beginning ESL (BGN ESL)
3.
Low Intermediate ESL (LOWINT ESL)
4.
High Intermediate ESL (HIGHINT ESL)
5.
Low Advanced ESL (LOWADV ESL)
6.
High Advanced ESL (HIGHADV ESL)
Record the date the test was administered.
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Chapter 10
Referral Form
Referral is a service provided by staff to assist registered clients in accessing the services of
partners and other agencies. The Referral Form is used to record and track a registered
client’s referral. This form is initiated by the person making the referral and should be
completed by the person verifying the status of the referral. Referral will show up on the
client’s referral page as well as on the service record. A Phone message does not constitute
a valid referral.
1
2
3
4
5
6
7
8
9
10
11
12
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1 Case Number
Click the appropriate button for the case number corresponding to the Enrollment under which services are
being provided. Select none, if the client is not enrolled.
2 Activity Type
The activity type will default to Referral.
3 Activity Code
Please use the appropriate Activity Code for the service provided. There are two activity codes available:
Code 93 referral for supportive services; and Code 94 for all other referrals. (Upon selecting the appropriate
activity code, the activity field will auto-fill.)
4 Referral From
Select the name of the agency that is providing the referral to the client. The system records the agency
associated with the logged in user. The referring staff member should check to make sure the agency name
reflects the name of the appropriate agency.
5 Referral To
Select the name of the agency where the client is being referred.
6 Purpose
Enter the reason that the client is being referred.
7 Referral Date
Enter the date that the client was referred.
8 Referred By
Select the name of the person responsible for this referral. The system will default to the person currently
logged into the system.
9 Follow-up Date
Enter the date that the referral agency was contacted to follow-up.
10 Follow-up By
The system records the information for the user as logged in on the CISRS home page. The provider
should check to make sure the User name reflects the name of the appropriate user.
11 Referral Result
Select from the following:
Showed up - the referral agency confirmed that the client showed up to receive services.
No show - the referral agency states that the client did not show up for services.
12 Change Log
The system records the date and the name of the logged in system user that entered this original record.
Then the system records the date, time, and name of the user who last edited this particular record.
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Chapter 11
WIA Placement Form
A Placement Form is recorded any time a client is placed in unsubsidized employment. The
Placement Form should be filled out regardless of the participant’s status (Core A, Enrolled, or
prior to the completion of an Exit Form) or if the position is permanent or temporary. The
Placement Form must include the hours they are working per week, and their hourly wage.
Placements may include clients who enter the military and/or a qualified apprenticeship
program.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
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1 Employment Date
Enter the date the client entered employment. The Employment Date must be on or before the current date.
If the placement is going to occur in the future, document the information in the case notes and enter the
placement information in the placement form when the date is reached.
2 Employer Name
Select the Employer where the client is placed into employment. Use of the Employer Name field
automatically fills in the Employer Address, Employer City, State, and Employer Zip, as well as the
Contact Person and Phone fields. This information is pulled from the Employer Database in CISRS and
should reduce data entry time when entering Placement Information. For example if a client is placed at
Ralph’s grocery store, a search of the employer name “Ralph’s” may return several entries. The user should
be careful to selecting the correct store. Once the user selects the employer names, all of the accompanying
information will be entered into the form.
3 Contact Person
This field displays the name of the contact person at the employer’s place of business who can verify
employment information. When the Employer Name is selected, the Contact Person field is automatically
filled. The user should verify this information, and update it if necessary. Do not leave this item blank.
4 Contact Phone
This field displays the telephone number, including the area code, of the contact person at the employer’s
place of business who can verify employment information. When the Employer Name is selected, the Contact
Phone field is automatically filled. The user should verify this information, and update it if necessary. Do not
leave this item blank.
5 Job Code/Title
Use the job code that best describes the individual’s type of employment. Record the SOC code that best
describes the individual’s type of employment as well as the title of the job. The job code will auto-fill the
Job Title field.
6 Industry Code/Title
Enter the first three-digits of the North American Industry Classification System (NAICS) industry code of
the employer’s industry.
7 Hours Per Week
8 Hourly Wage
Enter the hourly wage at placement. If the individual is paid by commission or receives a salary, convert to
the hourly wage by dividing the amount paid by the number of hours the individual is expected to work. The
term hourly wage includes any bonuses, tips, gratuities, commissions, and overtime pay earned.
If only a yearly salary is provided, AND the employee’s hours per week is known, divide by the projected
annual hours worked to arrive at the hourly wage. If the employee is known to be working 40 hours per
week, divide that number by 2080 to arrive at the hourly wage. For example, if a client’s salary is only
known as $32,000 a year, working 40 hours per week, to compute the hourly wage divide $32,000/2080 hours
= $15.38 an hour.
9 Training Related
Employment
Yes - The individual is placed into employment that uses a substantial portion of the skills taught in the
training received by the individual WHILE enrolled in the WIA program, regardless of if the training
was WIA funded or not.
No - The employment the participant entered was not related to the participant’s training while enrolled in the
WIA program.
This field is especially important for WIA funded training, such as an ITA, OJT, or Customized
Training.
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May 2010
10 Determination Method
If you answered Yes to the previous questions, click the appropriate button.
Otherwise, skip.
Training to job
Comparison of the occupation codes between the training activity and the job.
Industry to training
Comparison of the industry of employment with the occupation of training using an appropriate crosswalk.
Other
Another method was used.
11 Health Benefits
Yes
Use if the employment provides the individual with health insurance benefits. If the client is exited before the
benefits begin, use YES if benefits will begin within 90 days of employment.
No
Use if the employment DOES NOT provide the individual with health insurance benefits.
12 Non-Traditional
Employment
Use the appropriate code. Both males and females can be in nontraditional employment. Refer to WIA
Standardized Record Data, Attachment E, Appendix D, for information that may be used for determining nontraditional employment.
Yes
The participant has been placed in an occupation or field of work for which individuals of the participant’s
gender comprise less than 25% of the individuals employed in such occupation or field of work [WIA Section
101(26)].
No
The participant does not meet the above stated criteria.
13 Non-Covered
Employment
This field is to be used ONLY if the client is employed in a job that would not be included (“non-covered”) in
the Unemployment Insurance (UI) Base Wage File data. Employment that would fall into this category
includes Out of State Employment, Military or Federal Employment, the Self-Employed, or those individuals
working in a religious organization recognized under section 501(c)3 of the Internal Revenue Service. If
“Yes” is selected in this field, during the 1st and 3rd Quarter Follow-up contacts, the user will need to verify
and document that the individual is employed, in order to receive credit for a placement in the performance
measures that use UI Base Wage File data to determine entered employment rate and/or retention rate.
13 Change Log
The system records the date and the name of the logged in system user that entered this original record. Then
the system records the date, time, and name of the user who last edited this particular record.
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Chapter 12
Exit Form
The Exit Form is used to record the exit of a client from a WIA program. This form should
only be used when a client has completed all services (except follow-up services), including
partner services, or when they are not expected to return. Multiple exit codes (up to 3) are
acceptable, and often are encouraged, to ensure a positive exit for performance measurement.
The Placement Form must be completed before this form if the participant is being exited as
Entered Employment or Called Back/Remained with Lay-Off Employer.
If a client accessed a training service and received a credential, select exit code 05 “Attained
Recognized Certificate/Diploma/Degree.” Additionally, enter the “Degree Attained,”
“Date Degree or Certificate Attained,” and “Type of Degree Attained.”
If there are activities on the Service Record that do not have an end date, this form will not be
saved. You must return to the Service Record and indicate completion dates for all activities.
Please note: The exit date must be the same as the end date of the last recorded activity.
Participants can be excluded from performance measures, at the time of exit, for any of the
following circumstances that precludes the participant from entering into employment or
participating in services:
• family care reasons,
• participant health or medical condition,
• participant deceased,
• participant institutionalized,
• participant is a military reservist recalled to active duty, or
• youth who are relocated to mandated residential programs.
These neutral exits must be substantiated by documents such as disability insurance
documentation, physician’s or hospital records, police or penal institution records, military
records, telephone verification with a cognizant agency, obituaries, newspaper articles, or
when no other documentation is available the use of Applicant Statements. This
documentation must be accompanied by detailed case notes. This is particularly important
when Applicant Statements are used, and these case notes must also show a good faith effort
to obtain other written documentation when an Applicant Statement is used.
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1
2
3
1
2
3
4
5
6
7
8
9
10
11
12
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14
15
16
17
18
19
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5
6
7
8
9
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10
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The application number is assigned automatically by the system. If no number exists, leave blank for
automatic generation by the CISRS system.
2 Education Status
Select the Education Status at Exit from the following categories.
(including elementary, intermediate, junior high school, secondary or postsecondary school) or is between
school terms and intends to return to school.
Student, attending postsecondary school - The client is a high school graduate (or equivalent) and is
attending postsecondary school or is between school terms and intends to return to school.
Out-of-School, H.S. graduate, employment difficulty - The client is not attending any school, is a high
school graduate, and is basic skills deficient, unemployed, or underemployed.
Out-of-School, H.S. graduate, no employment difficulty - The client is not attending any school, is a high
school graduate and is not basic skills deficient and not unemployed and not underemployed.
3 Exit Code
The following explanations will help determine which exit codes to use and when.
Case notes should be used to record the circumstances or any detail of the exit not captured by the following
definitions.
1 = Entered Employment
The client entered full or part-time employment. This includes clients who enter the military and/or a
qualified apprenticeship program. Use this code when a client has entered full or part-time employment and
no further services other than follow-up services are requested and/or deemed necessary. For the Career
Center Network and Youth Programs, there is no weekly hour worked or wage requirement for using
this code. Other programs may need to refer to their contracts for alternate standards. A completed
Placement Form MUST be completed in order to use this code and employment MUST be documented in
the client case file to use this exit code. Documentation would include any verification of employment,
including telephone and e-mail verification, with proper documentation by the client, employer, or other
agency.
If this exit code is selected, and the client has more than one employment placement record, the user will be
prompted to select the placement that should be designated as the “exit placement”.
This is a positive exit for Adult, Dislocated Worker and Youth.
2 = Called Back/Remained
with Layoff Employer
Use this code if the client was called back by or remained with the layoff employer. Use this code when a
client has entered full or part-time employment and no further services other than follow-up services are
requested and/or deemed necessary. For the Career Center Network, there is no weekly hour worked
or wage requirement for using this code. Adult special programs providers need to refer to their
contracts for their standards. A completed Placement Form MUST be completed in order to use this
code and employment MUST be documented in the client case file to use this exit code. Documentation
would include any verification of employment, including telephone and e-mail verification, with proper
documentation by the client, employer, or other agency.
If this exit code is selected, and the client has more than one employment placement record, the user will be
prompted to select the placement that should be designated as the “exit placement”.
This is a positive exit for Dislocated Workers.
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May 2010
3 = Entered Advanced
Training
The client entered non-WIA-funded advanced training. Advanced training is an occupational skills and
employment or training program, not funded under WIA Title I, which does not duplicate training received
under WIA Title I. Training that leads to an academic degree (e.g., AA, AS, BA, BS) should be categorized
as post-secondary education and not reported as advanced training. Advanced training may be provided by
a partner following the exit of the registrant from WIA. Advanced training does not include training funded
partially or wholly with WIA funds. An example of advanced training is a community college program that
does not lead to an advanced degree.
Please Note: A detailed case note must include information on the start date of the training, the type of
training, and the name of the educational institution.
For Youth, this is a positive exit.
4 = Entered Post
Secondary Education
The client entered an accredited degree-granting institution that leads to an academic degree (AA, AS, BA
or BS).
Please Note: A detailed case note must include information on the start date of the postsecondary education
program, the type of program, and the name of the educational institution.
For Youth, this is a positive exit.
5 = Attained Recognized
Certificate/Diploma/Degree
The client obtained a nationally recognized degree or certificate or a state recognized credential, or
certificate (i.e. a local certificate obtained from ROP). This includes high school diplomas and GED. This
code must be used if the client was enrolled in a Training Activity, both WIA funded and Non-WIA funded,
while receiving WIA services, and received a certificate or diploma. If this code is used, the information
regarding “Degree Attained”, “Type of Degree Attained” and “Date Attained” fields must be
completed. This code must be used for Youth who have attained a diploma or equivalent at exit.
For Adults or Dislocated Worker clients, this would be considered a positive exit only if used in
conjunction with another positive exit code (i.e. “1=Entered Employment” or “2= Called Back with
Layoff Employer”).
For Youth this is a positive exit, as long as the youth was enrolled in education or training.
6 = Planned Services
Completed
The individual’s WIA service goals were completed, and the individual is no longer receiving services
(excluding follow-up services).
By itself, this exit code is not a positive exit. It is used only for informational purposes. It may be
used to more fully describe a client’s exit status, but is not a positive outcome for performance
purposes.
7 = Planned Services Not
Completed
The individual’s WIA service goals were not completed, and the individual is no longer receiving services
(excluding follow-up services).
purposes.
8 = Lacks Transportation
Use this code if the client is without a means of transportation that precludes entry into employment or
continued participation in WIA.
purposes.
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May 2010
9 = Family Care
Use this code if the client is responsible for the care of one or more family members, which precludes entry
into employment or continued participation in WIA.
This is a neutral exit. Do not use with another Exit Code.
10 = Health/Medical
Use this exit code if the client is receiving medical treatment, which precludes entry into employment, or
continued participation in WIA, other than temporary conditions expected to last less than 90 days. This
does not apply to the health of a client’s family member. If the client exits WIA services to care for a
family member, the exit code “Family Care” (exit code 9) should be used.
Health/Medical exits need to be substantiated by documentation such as Disability Insurance
documentation, physician's letters, Applicant Statements or Telephone Verification/Document Inspection
Form. As a last resort, case notes alone will suffice but they must be as detailed as possible.
Documentation must be accompanied by detailed case notes, particularly when Applicant Statements are
used. Case notes must also show a good faith effort to obtain other written documentation.
11 = Cannot Locate
Use this code when the client cannot be located despite attempts by phone, mail, e-mail, and additional
contact information provided by the client to locate them. Please document attempted contact with client by
including a copy of any written correspondence, such as postcards, letters, and e-mail in the case file and
documenting it in the case notes.
purposes.
12 = Death
The client is deceased. This exit needs to be substantiated by documentation such as
obituaries, newspaper articles, a physician’s letter, Alternate Contact Statements or Telephone
Verification/Document Inspection Form. As a last resort, case notes alone will suffice but they must be as
detailed as possible. Documentation must be accompanied by detailed case notes, particularly when
Applicant Statements are used. Case notes must also show a good faith effort to obtain other written
documentation.
13 = Institutionalized
Use this code if a client resides in an institution or facility providing 24-hour support such as a hospital or a
prison and is expected to remain in that institution for at least 90 days. This exit code cannot be used unless
it is documented how it was determined that the client was institutionalized in the client file and case note.
Institutionalized exits need to be substantiated by documentation such as newspaper articles, Applicant
Statements or Telephone Verification/Document Inspection Form. As a last resort, case notes alone will
suffice but they must be as detailed as possible. Documentation must be accompanied by detailed case
notes, particularly when Applicant Statements are used. Case notes must also show a good faith effort to
obtain other written documentation.
14 = Voluntary Other
Use this code when a client voluntarily leaves the WIA program for reasons other than any of the other
possible exit codes. This occurs when a client specifically does not want any further services, refuses to
comply with requests for information, and/or will not respond to contact attempts when located. This exit
code should not be used unless it is documented in the client file and case note why it was that the client left
the WIA services.
purposes.
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15 = Objective Assessment
Only
This exit code is no longer used. The client received only objective assessment services. After July 1, 2000,
those clients terminated with objective assessment only will be counted in WIA performance measure
calculations.
Do not use this Exit Code. This Code would be a negative exit.
16 = Returned to
Secondary Education
(Youth Only)
The youth is enrolled in secondary school following their exit from the program. Younger youth that exit
and return to secondary school are excluded from the younger youth diploma or equivalency rate and the
younger youth retention rate performance measures. These younger youth are only included in the younger
youth skill attainment rate performance measure.
purposes.
17 = Soft Exit
A participant does not receive any WIA-funded or non-WIA funded partner services for 90 days and is not
scheduled for future services except follow-up services (soft exit). If a participant is soft exited, the exit date
will be the ending date of the last activity prior to the expiration of the 90 days.
This code is to be used only by Workforce Partnership staff. It is a negative exit.
18 = Reservists Recalled
Use this code if a client is a Reservist recalled to active military duty.
19 = Mandated Residential
Program (Youth Only)
Use this code if a youth is unable to continue program participation or meet program outcomes due to the
youth’s relocation to a mandated residential program.
4 Placement Detail
5 Exit Date
If the participant is being exited with exit codes Entered Employment (01) or Called Back/Remained with
Layoff Employer (02), then the name of the company entered on the client’s Exit Placement Form (see Exit
Codes 01 and 02 above) will be displayed. This information is view only and can only be changed if the
information on the Placement Form is changed.
Enter the last date on which WIA Title I or partner services were received by the individual, excluding
follow-up services. The exit date must be on or after the date of the last activity received before the client
exits from the program. There are two ways to determine exit:
A. A participant has a date of case closure, completion or known exit from WIA-funded or nonWIA funded partner services;
B. A participant does not receive any WIA-funded or non-WIA funded partner services for 90
days and is not scheduled for future services except follow-up services.
A planned gap in service of greater than 90 days should not be considered an exit if the gap is due
to a delay before the beginning of training or a health/medical condition that prevents an
individual from participating in services. This should be identified as a planned gap in service
(Activity Code #83 or #86), on the Service Record. Service providers should document any gap in
service that occurs with a reason for the gap.
6 Soft Exit Determination
Date
This field is to be used by San Diego Workforce Partnership staff only.
This field represents the day a soft exit is determined (not the last day of services received). A participant
may be soft-exited when the client does not receive any WIA-funded or non-WIA funded partner services
for 90 days and is not scheduled for future services except follow-up services (soft exit).
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7 Degree Attained
The following codes are to be used for Adult and Dislocated Workers and for all Youth clients that
are enrolled under WIA AND receive either WIA funded OR Non-WIA funded training. If an exit
code of “Attained Recognized Certificate/Diploma/Degree” (Code 5) is used, this field must also be
completed.
This measure is scrutinized by the State in measuring Local Workforce Investment Area performance of the
credential attainment rate.
1 Yes –Use if the client was enrolled in an Education or Training program and a degree, certificate, or a
credential was received. This includes a high school diploma or GED. A copy of the certificate, diploma,
or credential MUST be included in the client file, as well as being documented in the case notes.
2 No, credential intended – Use if the client was enrolled in an Education or Training program and a
degree, certificate, or a credential was intended, but not received. Do not use if it is pending.
3 No, credential not intended – Use if the client was enrolled in an Education or Training program and a
degree, certificate, or a credential was not intended. Do not use if it is pending.
4 No, credential pending – Use if the client was enrolled in n Education or Training program and a degree,
certificate, or a credential was not received but is pending. The achieved degree, certificate, or credential
can be captured at follow-up.
5 No training services provided – Use if the client was not enrolled in n Education or Training program.
If Degree Attained is answered as “Yes”, select one of the following.
8 Type of Degree Attained
1 High School Diploma
2 Equivalency/GED
3 AA or AS Diploma/Degree
4 BA or BS Diploma/Degree
5 Occupational Skills License
6 Occupational Skills Certificate or Credential
9 Other
9 Date Degree or
Certificate Attained
Enter the date the client received a degree or certificate or credential, if applicable. This degree or
certificate or credential must be documented in the client’s case file. This date may not be greater than the
exit date.
10 Entered Post Secondary
Education
The client entered an accredited degree-granting institution that leads to an academic degree (AA, AS, BA
or BS). This field is used in conjunction with Exit Code “04- Entered Post Secondary Education”.
11 Entered Advanced
Training
The client entered non-WIA-funded advanced training. Advanced training is an occupational skills and
employment or training program, not funded under WIA Title I, which does not duplicate training received
under WIA Title I. Training that leads to an academic degree (e.g., AA, AS, BA, BS) should be categorized
as post-secondary education and not reported as advanced training. Advanced training may be provided by
a partner following the exit of the registrant from WIA. Advanced training does not include training funded
partially or wholly with WIA funds. An example of advanced training is a community college program that
does not lead to an advanced degree.
This field is used in conjunction with Exit Code “04- Entered Advanced Training”.
12 Entered Military
Service
Military service is defined as reporting for active duty and is considered employment for Adults, Dislocated
Workers and Youth. In order for this to count as a placement, a Placement Form MUST be completed and
the client must be exited using “01-Entered Employment”.
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13 Entered Qualified
Apprenticeship
Qualified apprenticeship is defined as a program approved and recorded by the ETA/Bureau of
Apprenticeship and Training (BAT) or by a recognized State Apprenticeship Agency (State Apprenticeship
Council). Approval is by certified registration or other appropriate written credential. If the apprenticeship is
paid, for it to count as a placement a Placement Form MUST be completed and the client must be exited
using the exit code “01-Entered Employment”.
14 Exit Staff
The system records the information for the user as logged in on the CISRS home page. The provider should
check to make sure the Exit Staff name reflects the name of the appropriate user.
15 Exit Notes
The used may enter notes related to the exit.
16 Agency Name
The system records the agency name selected by the logged-in user on the CISRS home page. The provider
17 Contract Name
The system records the contract ID selected by the logged-in user on the CISRS home page. The provider
should check to make sure the contract ID reflects the name of the appropriate contract. If none was
selected on the CISRS home page, the user must select the appropriate contract ID here.
18 Change Log
The system records the date and the name of the logged in system user that entered this original record.
Then the system records the date, time, and name of the user who last edited this particular record.
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Chapter 13
Follow-Up Form
Introduction and Form Purpose
The Follow-up Form is used to record the information from WIA-registered participants
during follow-up contacts after exit. A follow-up contact is a check to determine a client’s
employment and educational status after exiting the WIA program. The information reported
in this form may be used to measure retention and other post-program performance
outcomes.
By using the information requested on the form, staff will be able to determine a client’s
employment and educational status at these intervals. This follow-up contact procedure will
ensure that participants employed at exit have remained employed, and to collect and record
supplemental employment information for those participants employed in jobs not covered
by the UI Base Wage File (For Youth this would also include those who entered post
secondary education, advanced training, the military, or a qualified apprenticeship). The
form also records information that was not available at exit, such as credential attainment that
may have occurred after exit. The information on the form may come from a variety of
sources, as appropriate, including the client, the employer, school records, or other service
providers/partners who can validate the client’s status.
Follow-up Form vs. Follow-up Services
These follow-up contacts, where data is required to be collected and recorded on the Followup Form, should not be confused with Follow-up Services. While the Follow-up Form
requires that specific data be collected at the set intervals, Follow-up Services are those
activities that are provided to clients to help ensure retention. Follow-up services may be
provided at the time the follow-up contact is due (i.e. at the 1st quarter after exit), or at any
other time beneficial to the client. Follow-up services are recorded on the Service Record by
adding a Post-Exit Activity in CISRS.
Exclusions from Performance Measures after Exit
By using the relevant Follow-up Result codes, clients can be excluded from post-exit
performance measures due to any of the following circumstances that precludes the
participant from entering into employment or participating in services:
- family care reasons, or
- participant health or medical condition,
- participant deceased,
- participant institutionalized,
- participant is a military reservist recalled to active duty,
- youth who are relocated to mandated residential programs.
(Operations Issuance 2006-08, Feb 24, 2006)
These exclusions apply to the post-program follow-up period during the 3 quarters after exit.
This will allow the exclusion of participants from relevant after-exit or retention measures, at
any follow-up period (1st Qtr, 2nd Qtr, or 3rd Qtr). Exclusions at follow-up may be used when
a condition exists at follow-up that did not exist at exit. For example, a participant is
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employed at exit, but incarcerated at 1st Qtr follow-up, or is a reservist recalled to active duty
during the 3rd Qtr follow-up.
These exclusions must be substantiated by documents such as disability insurance
documentation, physician’s or hospital records, police or penal institution records, military
records, telephone verification with a cognizant agency, obituaries, newspaper articles, or
when no other documentation is available the use of Applicant Statements. This
documentation must be accompanied by detailed case notes. This is particularly important
when Applicant Statements are used, and these case notes must also show a good faith effort
to obtain other written documentation when an Applicant Statement is used.
Follow-up Due Dates and Timing
This form currently MUST be used at the 1st and 3rd quarter after exit from the program. The
same form type is used for each contact, with an indicator of the follow-up period being
selected. It is recommended and encouraged that follow-up contacts be conducted with
clients at more frequent intervals than once a quarter, in order to keep in touch with clients
and ensure retention. However, those contacts would not necessarily require the collection of
detailed information as required in the Follow-up form. Adult and Youth providers should
refer to their contracts for additional mandatory follow-up data collection requirements.
Regular, frequent contact is important for all clients, as retention performance outcomes
occur in the third quarter. It is also particularly important for youth because follow-up
services are also REQUIRED to be provided to youth for twelve months after exit.
For Follow-up contacts due at the quarter intervals (1st, 2nd, 3rd, 4th), the Follow-up due date
is the first day of the quarter following the quarter in question. For example, if a participant
exits February 12, 2007, their Exit Quarter is January - March 2007, and their 1st Quarter
after Exit is April - June 2007. Their 1st Quarter follow-up contact would therefore be due on
July 1, 2007. Their 3rd Quarter after Exit is October - December 2007, and their 3rd Quarter
follow-up contact would be due on January 1, 2008. (See the following example and
timeline.)
Following this process, there are only four follow-up due dates for the quarters after exit:
July 1, October 1, January 1, and April 1. On or shortly after that date, it can be determined
whether the participant had a positive outcome at any time during the previous quarter.
The due date is set this way in order to conduct the follow up contact after the entire quarter
in question has passed, before determining whether a participant is employed (1st Quarter) or
retained (3rd Quarter) at any time during that quarter. In the example above, if the Adult
participant loses the job he had at exit, and is not re-employed until June 15, he would still be
considered employed during the 1st Quarter after exit, even though he wasn’t employed for
the entire quarter.
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Determination of the outcome for that quarter can be made through a follow-up contact that
is conducted on or shortly after that date (i.e. first few weeks of July), or it can be made using
information obtained from follow-up contacts that occurred during the quarter in question.
Please note: Although data can be collected before the due date, it cannot be input into the
CISRS Follow-Up Form before the due date. For data that is collected before the due date, it
is appropriate to use the due date as the Interview Date when inputting the data into the form.
Example: Exit = Feb. 12, 2007
1st Qtr FU contact due = July 1, 2007
Must be
employed at any
time during April
1 - June 30
FU Interview must be conducted and input by July 31,
2007
Quarterly Performance Reported in October 2007.
Qtr.
Mo.
Yr.
Program Year 06/07
3
4
Jan Feb Mar Apr May Jun
2007
2007
1st Qtr
Exit Qtr
Action 1st Qtr FU
Program Year 07/08
1
2
3
4
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
2007
2007
2008
2008
2nd Qtr
3rd Qtr
4th Qtr
Action 2nd Qtr
FU
Reporting
1st Qtr FU
Action 3rd Qtr
FU
Reporting
2nd Qtr FU
107
Action 4th Qtr
FU
Reporting
3rd Qtr FU
Reporting
4th Qtr FU
May 2010
1
2
3
4
5
6
7
8
9
10
108
May 2010
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
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May 2010
1 Follow-Up Type
(After Exit)
Choose the appropriate follow-up (30 day, 60 day, 90 day, 1st quarter, 2nd quarter, 3rd quarter, 4th quarter).
2 Follow-Up Due Date
Once this selection is made, the follow-up date will be assigned by the system based on the follow-up type and
the exit date. See a detailed explanation of the Due Date determination in the Introduction to this Chapter.
3 Interview Date
Enter the date of the follow-up interview. This date must be on or after the Follow-up due date. See the
Introduction to this Chapter for more information on the determination of the Interview Date.
4 Follow-up Result
Choose the appropriate result. Any result should be addressed in a Case Note to support the Follow-Up. For
more discussion on possible sources of information for this form, please see the introduction to this chapter.
1.
2.
3.
4.
5.
6.
7.
8.
9.
Complete: All Questions: The follow-up is complete, and all information solicited was collected and
documented.
Complete Interview: Missing Data: The follow-up is complete, however, some of the information
requested was either not provided or is otherwise missing.
Respondent Never Located: The contact information is invalid, or the respondent is otherwise not
located.
Located but Never Available: The respondent’s location is known, however attempts to follow-up
are not successful and the interview is not completed.
Informant Refused for Respondent: The interview is not completed and the participant never is
directly contacted. Another person refuses on behalf of the participant.
Respondent Refused Interview: The interview is not completed and the participant never finishes the
follow-up. The participant refuses.
Language Problem Prevented Interview: The interview is not completed because the respondent is
not able to answer all the questions provided due to language barriers.
Unable Due to Illness/Disability: The interview is not completed because of a medical or health
related condition that impairs the respondent’s ability to complete the follow-up interview. Using this
code excludes the participant from all performance measures for this and future follow-up periods.
Died/Incapable After Exit: The interview is not completed because the participant is deceased or is
not capable of completing the follow-up interview. This code may also be used for a participant who
has become institutionalized after exit, can no longer participate due to family care reasons, is a
military reservist recalled to active duty, or is a youth who has been relocated to a mandated
residential program. Using this code excludes the participant from all performance measures for this
follow-up period.
Select from the following:
1. Employed Full-Time - The participant is employed full-time if employed 32 hours a week or more
within seven days of the follow-up contact period. This is a positive retention category for Adults,
Dislocated Workers, and Youth.
2. Employed Part-Time- Select if the client is working less than 32 hours per week. This is a positive
retention category for Adults, Dislocated Workers, and Youth
3. Unemployed – Select if the participant is not employed at the time of follow-up.
4. Not in Labor Force – Select if the participant is no longer a member of the labor force at the time of
the follow-up.
5. Status Unknown - Select if the labor status of the participant is unknown at the time of the follow-up.
6 Supplemental Data
Verified Employment
Status First Quarter
after Exit
Yes -- In the first quarter after exit, the client is employed in a job that would not be included in the
Unemployment Insurance (UI) Base Wage File data. Employment that would fall into this category includes
Out of State Employment, Military or Federal Employment, the Self-Employed, or those individuals working in
a religious organization recognized under section 501 (c) 3 of the Internal Revenue Service. Verification will be
needed to receive credit for a placement, affecting the entered employment rate and/or retention rate.
No – The client is employed in the first quarter after exit, but is in a job that is included in the UI Base Wage
File data.
N/A – The client is not employed in the first quarter after exit
Yes -- In the second quarter after exit, the client is employed in a job that would not be included in the
7 Supplemental Data
110
May 2010
Verified Employment
Status Second Quarter
after Exit
No – The client is employed in the second quarter after exit, but is in a job that is included in the UI Base Wage
File data.
N/A – The client is not employed in the second quarter after exit.
8 Supplemental Data
Verified Employment
Status Third Quarter
after Exit
Yes -- In the third quarter after exit, the client is employed in a job that would not be included in the
No – The client is employed in the third quarter after exit, but is in a job that is included in the UI Base Wage
File data.
N/A – The client is not employed in the third quarter after exit.
9 Date Degree or
Certificate Attained
This applies to participants that attain a degree after exit. Enter the date the client received a degree or certificate
or credential, if applicable. This degree or certificate or credential must be documented in the client’s case file.
10 Type of Degree
Attained
1. High School Diploma
2. Equivalency/GED
3. AA or AS Diploma/Degree
4. BA or BS Diploma/Degree
5. Occupational Skills License
6. Occupational Skills Certificate or Credential
9. Other
11 Continuing In Post
Secondary Education
Yes -- The participant is enrolled in a postsecondary educational program. This applies to participants that enter
post secondary education after exit. This is a positive retention category for youth.
No -- The participant is not enrolled in a postsecondary educational program.
12 Continuing In
Advanced Training
Advanced training is an occupational skills and employment or training program, not funded under WIA title I,
which does not duplicate training received under WIA Title I. Training that leads to an academic degree (e.g.,
AA, AS, BA, BS) should be categorized as post-secondary education and not reported as advanced training. A
WIA partner following the exit of the registrant from WIA may provide advanced training. Advanced training
does not include training funded partially or wholly with WIA funds. An example of advanced training is a
community college program that does not lead to an advanced degree.
This applies to participants that enter Advanced Training after exit. This is a positive retention category for
youth.
Yes -- The participant is enrolled in an advanced training program.
No -- The participant is not enrolled in an advanced training program.
13 In Military Service
Military service is defined as reporting for active duty, or being recalled, and is considered employment. If
seeking credit for employment, the Labor Force Status field must be completed as “employed”, along with the
supplemental data field.
This applies to participants that enter Military Service after exit. This is a positive retention category for youth.
Yes -- The participant is in the military service.
No -- The participant is not in the military service.
111
May 2010
14 In Qualified
Apprenticeship
Qualified apprenticeship is defined as a program approved and recorded by the ETA/Bureau of Apprenticeship
and Training (BAT) or by a recognized State Apprenticeship Agency (State Apprenticeship Council). Approval
is by certified registration or other appropriate written credential.
This applies to participants that enter a Qualified Apprenticeship after exit. This is a positive retention category
for youth.
Yes -- The participant is in a Qualified Apprenticeship.
No -- The participant is not in a Qualified Apprenticeship.
15 Weeks Employed
Enter the cumulative number of weeks the participant has been employed during the follow-up period. The
weeks employed should be a running total that begins with the exit date.
16 With Exit Employer
Yes -- The participant is employed with the same employer as reported at exit.
No -- The participant is not employed with the same employer as reported at exit.
17 Actual Hours
Worked
Enter the actual cumulative number of total hours the participant worked for the employer during the follow-up
period, including overtime. The actual hours worked should be a running total that begins with the exit date.
18 Date Employed
Enter the date the client entered employment.
19 Employer Number
Use of the Employer number automatically fills in the gray areas of the form including Employer Name,
Employer Address, Employer City, State, and Employer Zip. This information is pulled from the Employer
Database in CISRS and should reduce data entry time when entering employer Information. It is possible to
search by many criteria including the city, business name, and employer number if known. For example if a
client is placed at “Ralph’s”, a search of the employer name “Ralph’s” may return several entries, by selecting
the correct store, all of the accompanying information will be entered into the form including the employer
number.
20 Contact Person
Record the name of the contact person at the employer’s place of business who can verify employment
information. Program provider staff may not be used as Employer Contact. Do not leave this item blank.
21 Contact Phone
Record the employer’s contact telephone number including the area code. Do not leave this item blank.
22 Job Code/Title
Use the job code that best describes the individual’s type of employment. Record the SOC code that best
describes the individual’s type of employment as well as the title of the job. The job code will auto-fill the Job
Title field.
23 Industry Code/Title
Enter the first three-digits of the North American Industry Classification System (NAICS) industry code of the
employer’s industry.
24 Hours Per Week
25 Hourly Wage
Enter the hourly wage. If the individual is paid by commission or receives a salary, convert to the hourly wage
by dividing the amount paid by the number of hours the individual is expected to work. The term hourly wage
includes any bonuses, tips, gratuities, commissions, and overtime pay earned.
112
May 2010
projected annual hours worked to arrive at the hourly wage. If the employee is known to be working 40 hours
per week, an estimate of 2080 hours per year should be used. For example, if a client’s salary is only known as
$32,000 a year, working 40 hours per week, to compute the hourly wage divide $32,000/2080 hours = $15.38 an
hour.
26 Follow-up Staff ID
The system records the information for the user as logged in on the CISRS home page. The provider should
check to make sure the User name reflects the name of the appropriate user.
27 Agency Name
The system records the agency name selected by the logged-in user on the CISRS home page. The provider
28 Contract
The system records the contract ID selected by the logged-in user on the CISRS home page. The provider
should check to make sure the contract ID reflects the name of the appropriate contract. If none was selected on
the CISRS home page, the user must select the appropriate contract ID here.
29 Change Log
113
May 2010
Final page in Handbook
114
May 2010

CISRS Handbook - San Diego Workforce Partnership

Transcription

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