Vocational Rehabilitation Services
Vocational Adjustment Training (VAT)
Money Smart—A Financial Education Training
General Instructions
The vocational adjustment trainer followsthe instructions below when completing this form.
- Complete the form electronically (on the computer)and answer all questions.
- Write summaries in paragraph form in clear, descriptive English. Leave no blanks. Enter N/A if not applicable.
- Print the form, obtain signatures, and submit.
- Make certain that all standards are met before submitting this form with an invoice for payment.
Customer Information
Customer’s name: / VRS case ID:
Service authorization (SA)number:
Training Facts
Training facilitated: In a group setting (maximum of six customers for each trainer)
In an individual setting (one trainer to onecustomer)
A combination of group and individual settings
If training is facilitated in a group setting, record the VRS case IDs of all customers who participated in the group training session(s).
1. / 2. / 3.
4. / 5. / 6.
Traininginstructional approaches used in the delivery of the curriculumto meet the customer’s learning styles and preferences(Mark all that apply.):
Discussions / PowerPoint presentations / Inquiry-based instructions
Hands-on experiments / Project and problem-based learning / Computer-aided instructions
Others:Describe:
Attendance
Instructions:
- For each week of the training,enter the date (mm/dd/yy) of Monday through Sunday in the date column.
- For each day of the week, record the number of hour(s) the customer participated in the training.
- If customer is absent from the training, record an “A” for the day missed.
- Notify the counselor immediately when the customer is absent.
- Total the number of hours that the customer attended the training.
Week / Date
(Mon-Sun) / Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
1
2
3
4
5
6
Total number of hours customerparticipated in the training:
Customer’s Responses to Curriculum
Instructions:
- Record the date(s) each task listed within the module was completed.
- After the module is complete, use the scale below to rate the customer’s competency related to the skills and knowledge areas list below.
Key or Level / Description of Competency Level
Marginal /
- Limited or no understanding or knowledge
- Requires supervision the majority of the time
Basic /
- Basic understanding or knowledge
- Requires some guidance or supervision
Proficient /
- Detailed understanding or knowledge
- Capable of assisting others in the application of skills and tasks
- Requires minimum guidance or supervision and works independently
N/A /
- Not addressed, reason must be documented in Additional Comment Section
Money Smart—A Financial Education Training Curriculum Modules
Refer to the curriculum if you need additional information about activities. / Date Completed / Marginal / Basic / Proficient / N/A
Bank On It
Understands available banking services and how to build a positive relationship with a financial institution
Identifies five reasons to use a bank
Describes the steps involved in opening a bank account
Describes two types of deposit accounts
Identifies additional bank services that come with deposit accounts
Borrowing Basics
Understands how credit works, types of credit available, and whetherhe or she is ready to apply for credit
Defines “credit” and “loan”
Distinguishes between secured and unsecured loans
Identifies three types of loans
Identifies the costs associated with getting a loan
Identifies the factors lenders use to make loan decisions
Explains why installment loans cost less than rent-to-own services
Explains why it is important to be wary of rent-to-own, payday loan, and refund anticipation services
Describes how to guard against predatory lending practices
Check It Out
Understands how to use a checking account responsibly
States the benefits of using a checking account.
Determines which checking account is best
Adds and withdraws money from a checking account
Reconciles a check register with a bank statement
Identifies strategies to avoid overdrawing your account
Explains how debit cards are linked to checking accounts
Recognizes how to manage a checking account wisely, with proper debit card use and overdraft programs
Money Matters
Understands how to manage money by preparing a personal spending plan and identifying ways to decrease spending and increase income
Tracks daily spending habits
Prepares a personal spending plan or budget to estimate monthly income and expenses
Identifies ways to decrease spending
Identifies possible ways to increase income
Identifies budgeting tools that will help manage bills
Lists and prioritizes financial goals
Recognizes how to create a plan to achieve financial goals
Pay Yourself First
Understands ways to save money and options for meeting savings goals
Explains why it is important to save
Determines goals toward which you want to save
Identifies savings options
Determines which savings options will help you reach your savings goals
Recognizes investment options that will work for you
Lists ways you could save for retirement
Lists ways to save for large-expense goals, including child’s college tuition, car or home purchase, or a vacation
Keep it Safe
Understands how to protect their rights as customers and how to be financially prepared if a disaster strikes
Recognizes how federal deposit insurance protects deposits
Recognizes how to guard against identity theft
Recognizes how the various types of insurance will help you manage risks
Recognizes the need to plan for unexpected death or disability
Describesthe ways you need to be financially prepared for disasters
To Your Credit
Understands how to read a credit report and how to build and repair their credit history
Defines credit
Explains why credit is important
Describes the purpose of a credit report and how it is used
Orders a copy of their credit report
Reads and analyzes their credit report to determine if they are ready to apply for credit
Differentiates between “good” and “bad” credit
Describes the implications of “good” and “bad” credit scores
Identifies ways to build and repair your credit history
Recognizes how to correct errors on your credit report
Recognizes how to guard against identity theft
Charge It Right
Understands how to use a credit card responsibly and what to do when a credit card is lost or stolen
Defines credit
Explains why credit is important
Describes the purpose of credit cards
Determines if you are ready to apply for a credit card
Determines which credit card is best suited to you
Identifies the factors creditors look for when making credit decisions
Describes how to use a credit card responsibly
Identifies the steps to take when a credit card is lost or stolen
Loan To Own
Understands the characteristics of customer installment loans
Identifies various types of installment loans
Identifies the factors lenders use to make home loan decisions
Explains federal laws that protect the borrower when applying for a loan
Identifies the questions to ask when purchasing a car
Explains why installment loans cost less than rent-to-own services
Explains why it is important to be wary of rent-to-own, payday loan, and refund anticipation services
Explains how to guard against predatory lending practices
Your Own Home
Understands the home buying process and the difference between renting and owning and financially protecting their home
Pre-Homebuyers
Explains the advantages and disadvantages of renting versus owning a home
Identifies questions to ask to determine your readiness to buy a home
Identifies the steps required to buy a home
Identifies basic terms and required disclosures used in a mortgage transaction
Describes the advantages and disadvantages of different mortgage options
Describes how interest rates affect the “amount” of house you can buy
Explains how taxes and insurance affect a monthly payment and the “amount” of house you can buy
Homeowners
Describes the advantages and disadvantages of borrowing against a home
Explains what to do if you are having trouble making payments
Describes the different types of refinancing options
Explains the advantages and disadvantages of a reverse mortgage
Identifies predatory lending practices and loan scams
Financial Recovery
Learns about steps they can take to recover financially and rebuild their credit after experiencing a financial setback
Assesses their financial situation
Identifies ways to increase income and decrease and prioritize expenses
Develops a financial recovery plan
Identifies steps to successfully implement a financial recovery plan
Recognizes how to guard against credit repair scams
Identifies timeframes to review and adjust the financial recovery plan
Paying For College and Cars
Understands general information on installment loans (car loans and student loans)
Differentiates between secured and unsecured installment loans
Explains why installment loans cost less than rent-to-own services
Identifies the factors lenders use to make loan decisions
Identifies the questions to ask when purchasing a car
Describes various types of college loans and loan programs
A Roof Over Your Head
Understands information on the steps involved in renting an apartment and buying a house
Identifies initial and continuing costs of renting an apartment
Lists questions to ask when determining if you are ready to buy a home
Lists costs associated with renting and owning
Describes the benefits and pitfalls of renting versus owning a home
Extension activities: (One is required; describe below.)
1.
2.
Journaling activity: Topic Provided Yes No
Customer’s Overall Performance
Instructions: Use the scale to rate the customer’s overall performance.
Ability to learn / Excellent / Very Good / Good / Marginal / Poor
Accuracy of work / Excellent / Very Good / Good / Marginal / Poor
Accepts assistance / Excellent / Very Good / Good / Marginal / Poor
Adaptability / Excellent / Very Good / Good / Marginal / Poor
Appearance and hygiene / Excellent / Very Good / Good / Marginal / Poor
Attendance / Excellent / Very Good / Good / Marginal / Poor
Communication / Excellent / Very Good / Good / Marginal / Poor
Cooperativeness / Excellent / Very Good / Good / Marginal / Poor
Initiative / Excellent / Very Good / Good / Marginal / Poor
Motivation / Excellent / Very Good / Good / Marginal / Poor
Safety practices / Excellent / Very Good / Good / Marginal / Poor
Timeliness / Excellent / Very Good / Good / Marginal / Poor
Overall Training Summary
Describe the instructions and resources the customer received throughout the entire training.
Describe the customer’s ability and willingness to perform skills and tasks including all problematic issues or concerns that emerge.
Describe all accommodations, compensatory techniques, and special training needs required by the customer including why task had to be completed for the customer.
Recommendations related to future training that can enhance or improve the customer skills.
Additional Comments
Additional comments, if any:
Signatures
By signing below, I, the customer or authorized representative, agree with the information recorded within the report above. If you are not satisfied, do not sign. Contact your VR counselor.
Customer’s signature
X / Date:
Customer’s legally authorized representative’s signature, if any:
X / Date:
Provider Qualifications
Type of Provider: / Traditional-bilateral contractor / Transition Educator / Non-traditional
Traditional-bilateral contractor must complete the provider qualification section below. This section is not applicable to Transition Educator and Non-traditional providers.
Qualifications / Proof of Qualification / Verified by TWS-VRS
Specify UNTWISE Credential:
/ UNTWISE Credential Number:
if no, DARS3490-Waiver Proof Attached / Yes No N/A
Specify UNTWISE Endorsement:
N/A / UNTWISE Endorsement Number: / Yes No N/A
Select: RID BID
SLIPI N/A / RID/BID/SLIPI Number:
Proof Attached / Yes No N/A
Other: / Number: Proof Attached / Yes No N/A
By signing below, I, the Vocational Adjustment Trainer, certify that:
- the above dates, times, and services are accurate;
- I personally facilitated the Money Smart—A Financial Education Trainingcurriculum;
- all Money Smart—A Financial Education Training Outcomes Require for Payment as described in the TWC VR Standards for Provider and Service Authorization(s) were met;
- I personally documented the services and information described above on this form;
- the customer’s and/or customer’s legally authorized representative’s signature on this form was obtained on the date stated in the date field of the form;
- I handwrote my signature and the date below; and
- I maintain the staff qualifications required for a Vocational Adjustment Trainer as described in the TWC VR Standards for Providers or Service Authorization .
Vocational Adjustment Trainer typed name: / Vocational Adjustment Trainer signature:
X / Date:
Director Credentials and Signature
Required for Traditional-Bilateral Contractors
By signing below, I, the Director, certify that:
- I handwrote my signature and the date below; and
- I ensure that the staff meets the qualifications and met the requirements in the Standards for Providers when delivering the service and;
- I maintain the staff qualifications, including the UNTWISE credential, required for a Director, as described in Standards for Providers and/or Service Authorization.
Qualifications / Proof of Qualification / Verified by TWS-VRS
Specify UNTWISE Credential: / UNTWISE Credential Number:
if no, DARS3490-Waiver Proof Attached / Yes No N/A
Director’s typed name: / Director’s signature:
X / Date:
DARS Use Only—
Date Form Submitted by Provider:
Date Form Received by TWS-VRS Office:
Verification of Qualifications
The UNT website verifies that the director listed above is
NOT Credentialed Credentialed as a CRP Director
The UNT website or supporting documentation verifies the vocational adjustment trainer listed above is
NOT Credentialed
Credentialed as a Vocational Adjustment Training Specialist
Maintains BEI, RID, SLPI required for Premium
Endorsed in Other Specialization, Specify
- If the Director or Vocational Adjustment Trainer is not credentialed, is an approved DARS 3490, Temporary Waiver of CRP Credentials, attached to the invoice?
- If yes, does the DARS 3490 approve the director and/or vocational adjustment trainer for the dates the services?
If unable to verify the credentials, complete the following:
- Enter the date a copy of the submitted invoice, report and DARS3460 was sent to provider to notify the staff did not meet the qualification as defined in the Standards for Providers and/orSA.
- Enter the date a case note was made to document the return of invoice and required form(s)
Printed name of VRS staff member making verifications: / Date verified:
Approval of the Report
Verified that the report is accurately completed per form instructions, in the Standards for Providers, and/or the SA / Yes / No
Verified that the appropriate service(s) was provided as stated in the Standards for Providers and/or the SA / Yes / No
Verified that the form indicates that the training was provided in a group or individual setting and if a group setting a ratio of 1 Vocational Adjustment Trainer to no more than 6 customers was maintained / Yes / No
Verified that the attendance record indicates at least 30 hours of face-to-face training / Yes / No
Verified that the training provided to the customer contained the 14 required module topics / Yes / No
Verified that the training provided to the customer contained the 1 required extension activity / Yes / No
Verified that the journaling activities were offered during the training / Yes / No
Verified that the necessary accommodations, compensatory techniques, and special needs were provided and documented on the form by the vocational adjustment trainer as required for the customer’s successful engagement in the curriculum / Yes / No
Verified that the vocational adjustment trainer used and documented on the form the various instructional approaches to meet the customer’s learning styles and preferences / Yes / No
Verified that the vocational adjustment trainer provided all supplies and resources necessary for the customer to participate in the training through signature on form or by VR staff member contact with customer / Yes / No
Verified the customer’s satisfaction with the training through signature on the form and/or by VR staff member contact with customer / Yes / No
Verified that the appropriate fee(s) was invoiced / Yes / No
If any question above is answered “No,” complete the following:
- Enter the date a copy of the submitted invoice, the report and DARS3460 to notify the provider the service delivery or report did not meet the requirements as described in the Standards for Providers and/orSA. Date:
- Record a case note to document the return of invoice and required form(s)Date:
Report: Approved Sent back to provider
Comment (if any):
Printed name of VR staff member making verification: / Date Verified:
DARS3133 (10/17)Vocational Adjustment Training Money Smart—A Financial Education Training Page 1 of 9