Personal Information

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SProficiency Scale:

1: No experience

2: Need Training

3: Able to perform with supervision

4: Able to perform independently

Knowledge of Assessment Process

Psychosocial assessment (social history, living situation, career, hobbies, support systems, decision making, communication difficulties, flexibility, prolonged mental illness / emotional Problems, lack of community / caregiver support, family discord, ability to deal with loss)

Communication Abilities

Develop and maintain communication with people on complex matters, issues and ideas, and/or in complex situations

Personal and People Development

Develop oneself and contribute to the development of others

Quality Improvement & Service

Contribute to the improvement of services &maintain quality in own work and encourage others to do so

Care Planning

Assess complex health and well-being needs and develop, monitor and review care plans to meet those needs

Equality and Diversity

Promote equality and value diversity

Age Specific Competencies

Infant (Birth - 1 year)

Preschooler (ages 2-5 years)

Childhood (ages 6-12 years)

Adolescents (ages 13-21 years)

Young Adults (ages 22-39 years)

Adults (ages 40-64 years)

Older Adults (ages 65-79 years)

Elderly (ages 80+ years)

I hereby certify that ALL information I have provided to Tricehealthcare on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct.