SOCIAL WORKER Skills Checklist One program to handle all talent management needs from acquisition to development Personal Information This field is hidden when viewing the formOverall ScoreOut of 4Name(Required) First Middle Last Last 4 Digits of Social Security NumberEmail(Required) This field is hidden when viewing the formDate MM slash DD slash YYYY Proficiency Scale1 – No Experience 2 – Need Training 3 – Able to perform with supervision 4 – Able to perform independentlyKnowledge of Assessment ProcessPsychosocial 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)(Required) 1 2 3 4 Communication AbilitiesDevelop and maintain communication with people on complex matters, issues and ideas, and/or in complex situations(Required) 1 2 3 4 Personal and People DevelopmentDevelop oneself and contribute to the development of others(Required) 1 2 3 4 Quality Improvement & ServiceContribute to the improvement of services & maintain quality in own work and encourage others to do so(Required) 1 2 3 4 Health Protection & Well BeingImplement aspects of a protection plan and review its effectiveness(Required) 1 2 3 4 High risk intervention / patient vulnerability or safety risk(Required) 1 2 3 4 Monitor and maintain health, safety and security of self and others(Required) 1 2 3 4 Provide crisis intervention(Required) 1 2 3 4 Care PlanningAssess complex health and well being needs and develop, monitor and review care plans to meet those needs(Required) 1 2 3 4 Knowledge and InformationResourcesOrganize knowledge and information resources and provide information to meet needs(Required) 1 2 3 4 Demonstrates respect for patient/family confidentiality(Required) 1 2 3 4 Documentation Skills (accurate, timely, complete and legible)(Required) 1 2 3 4 Counseling for long range planning and decision making(Required) 1 2 3 4 Equality and DiversityPromote equality and value diversity(Required) 1 2 3 4 Experience in all or any of the following:Medical Social Work(Required) 1 2 3 4 School Social Work(Required) 1 2 3 4 Clinical Social Work(Required) 1 2 3 4 Social Work-Admin/management(Required) 1 2 3 4 Social work-case manager(Required) 1 2 3 4 International Social Work(Required) 1 2 3 4 Social Work-Children & Families(Required) 1 2 3 4 Social Work in Acute Psychiatric Hospital(Required) 1 2 3 4 Forensic Social Work(Required) 1 2 3 4 Employment/Occupational Social Work(Required) 1 2 3 4 Social Work- Community Organizer(Required) 1 2 3 4 Age Specific CompetenciesInfant (Birth - 1 year)(Required) 1 2 3 4 Preschooler (ages 2-5 years)(Required) 1 2 3 4 Childhood (ages 6-12 years)(Required) 1 2 3 4 Adolescents (ages 13-21 years)(Required) 1 2 3 4 Young Adults (ages 22-39 years)(Required) 1 2 3 4 Adults (ages 40-64 years)(Required) 1 2 3 4 Older Adults (ages 65-79 years)(Required) 1 2 3 4 Elderly (ages 80+ years)(Required) 1 2 3 4 AuthorizationsLegal Consent(Required) I agree to the terms and conditions.Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. 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In order to withdraw consent you must notify the “sending party” that you wish to withdraw your consent to transact business electronically and to provide your future documents, notices, and disclosures in paper format. If at any time, after withdrawing your consent you choose to use our electronic signature system your use of this Service will, once again, evidence your consent to receive documents, notices, and disclosures, electronically. You may withdraw your consent to receive electronic notices and disclosures or execute an electronic signature by following the procedures described below. Withdrawing your consent, requesting a paper copy, or updating your contact information You always have the ability to download and print any documents sent to you through our electronic signature system. 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