Ken’s Krew, Inc. 555 Madison Avenue 19th Floor New York, NY 10022 Office 212.290.8999 Fax 212.290.8994 www.kenskrew.org

Vocational Profile and Employment/Transition Readiness Applicant Information: Name _____________________________________________________________________________________ Address___________________________________________________________________________________________________________ Date of Birth ____________________

Home Phone Number __________________________ Cell Phone Number __________________

Provider’s Information: Name____________________________________ Phone Number____________________________

Relationship to applicant: ___________________

E-mail__________________________

This Vocational Profile is an assessment of the above candidate’s abilities and interests to be used in job development. To ensure an appropriate job match, honest and accurate information must be provided. Directions: The respondent should indicate what the person’s abilities and strengths are by circling the appropriate response to each question. If any additional comments are needed, please write in the margins of each category.

INDIVIDUAL PERFORMANCE, ABILITIES, AND STRENGTHS Self-Related Skills *What best describes the impulsivity of the young adult? Impulsive Impulsive, but responds to cues *What best describes the appearance of the young adult? Unkempt Inconsistent Neat *What best describes the hygiene of the young adult? Poor Inconsistent Clean

Controlled

*What best describes the young adult‘s truthfulness? Frequently lies Makes up stories

Almost always tells the truth

Never lies

*What best describes the young adult’s adaptability to change? Rigid routine required Adapts to change with great difficulty

Adapts to change with some difficultly

Smooth transition

*What best describes the young adult’s desire for paid employment? Negative about work Indifferent about work Interested in work with reservations

Positive about work

*What best describes the young adult’s self initiative? Avoids task Waits for directions

Sometimes seeks work

Always seeks work

*What best describes the young adult’s ability? Unaware of social security number (SSN)

Recognizes SSN

Memorized SSN

*The young adult knows (multiple answers): Address Phone number

Parent names

Emergency contacts

*The young adult is able to describe (multiple answers) Likes and dislikes Hobbies

Strengths

Other interests

*What best describes necessary accommodations required for the young adult? Visual/Perceptual Hearing Mobility Increased time for tasks

None

Task Related Skills *What best describes the young adult’s ability to distinguish between products? Cannot distinguish between work products Distinguishes between products with cue

Distinguishes between products

*What best describes the young adult’s stamina at work? Can work under 2 hrs. Can work between 2 - 4 hrs.

Can work over 4 hrs.

*What best describes the young adult’s ability to climb a ladder? Does not use a ladder 3-5 steps

5-8 steps

10-12 steps

*What best describes the young adult’s level of support needed to accomplish tasks after training has been completed? Continuous prompting required Some prompting required Little if any prompting required Works unsupervised 2

*What best describes the young adult’s pace when working independently? Slow Varies

None

*What best describes the young adult’s attention span? Needs frequent cues Needs some cues

Remains focused

*What best describes the young adult’s accuracy when completing a task? Many mistakes Some mistakes

Few to no mistakes

*What best describes the young adult’s ability to complete tasks within time allotted? Does not complete tasks Usually completes tasks Always completes tasks *What best describes the young adult’s task persistence? Easily becomes frustrated and shuts down

Willing to attempt several times before shutting down

Seeks help when unable to complete task

Independently problem solves until completed

*What best describes the young adult’s response to corrective instruction? Reacts negatively Sensitive/becomes emotional Shuts downs

Accepts/Follows redirection

*What level of supervision is needed once intensive training has been completed? Daily Weekly

Bimonthly

*What best describes the young adult’s ability to perform tasks in sequence? Cannot perform tasks in sequence Performs 2-3 tasks in sequence

Performs 4-6 tasks in sequence

*What best describes the young adult’s time awareness? Recognizes time on digital watch Recognizes time on a clock

Can tell time on digital watch

*What best describes the young adult’s on time behavior? Frequently tardy Generally on time

Can tell time on clock

Always punctual

*What best describes the young adult’s reading ability? Identifies symbols Sight words

Simple reading

3

Fluent reading

*What best describes the young adult’s math ability? Simple counting Simple addition and subtraction *What best describes the young adult’s money skills? Basic coin and dollar recognition Uses money in vending machines

Is able to match numbers that are the same

Knows value of coins/dollars

*What best describes the young adult’s computer skills? Unable to use computer Uses computer for games

Can compute change

Uses keyboard to copy words/numbers

Interpersonal Skills *What best describes the young adult’s ability to request help? Unable to ask for help

Will ask for help with prompt

Seeks help, but maybe in an inappropriate manner

No problem asking for help

*What best describes the young adult’s manners? Lacks good manners Generally very polite (please, thank you)

Always courteous and respectful

*What best describes the young adult’s eye contact? Never Sometimes - when in a comfortable situation

Almost always conveys appropriate eye contact

*What best describes the young adult’s preference to engage in activity? Alone Sometimes in a group

Always in a group

*What best describes the young adult‘s ability to initiate conversations? Rarely initiates conversation Reluctant to speak Easily initiates conversation

Communicates with ease

*What best describes the young adult‘s ability to terminate conversations? Unable to identify when it is appropriate to end conversation Generally able to conclude conversation appropriately *What best describes the young adult‘s cooperation level during social activities? Reluctant to interact Interacts frequently

Always interacts

*What best describes the young adult‘s demonstration of respect for others’ feelings and property? Generally disrespectful of others Sometimes has difficulty with issues of respect Always considerate of others 4

ADDITIONAL INFORMATION - Please complete with as much detail as you feel is necessary Additional accommodations needed for job success: ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ Interests or preferred activities: _______________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________

Pertinent Medical Information (seizures, medications, hearing/visual impairment, etc.): _______________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________

I, ________________________________, hereby state that I completed this Ken’s Krew, Inc. Vocational Profile for ___________________________________, a candidate for the Ken’s Krew, Inc. Program. I believe what I have written to be true to the best of my knowledge based on my experience with the candidate in the home/school/work setting.

Signature: ____________________________________________

Date: ____________________________ 5