Individual Employment Plan

Out-of-School Name of Participant: Sacramento Employment & Training Agency

------INDIVIDUAL EMPLOYMENT PLAN (Individual Service Strategy) ------

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Academic Skills Level and Goal:

School Drop Out: Yes or No

High School Diploma: Yes or No

High School Equivalency: Yes or No

GED: Yes or No

GED Prep Class:

Date:

HiSET: Yes or No

HISET Prep Class:

Date:

Academic Goal:

Short-Term Academic Goal:

Long-Term Academic Goals:

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ACADEMIC ASSESSMENTS & RESULTS: CASAS

Reading (Pre-Test):

Basic Skills Deficient: Yes or No or N/A (Disability)

Score:

EFL:

Math (Pre-Test):

Basic Skills Deficient: Yes or No

Score:

EFL:

Requires Remediation (pick the lowest score): Yes or No

Math: Yes or No or

Reading: Yes or No

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Career Exploration tool used:

Interest Profiler Results:

Career Pathway Choice: ______

Indicate the category career choice falls

(WEX): (check all that apply):

___Administrative and Support Services

___Construction/Clean Energy

___Healthcare Services (Life Sciences)

___Information and Communication Technology

___Installation, Maintenance and Repair

___Agriculture, Food and Hospitality

___Transportation and Production

Other: ______

Employment Goal:

Short Term Employment/Educational Goal:

Long-Tern Employment/Educational Goal:

Post-Secondary: Yes or No

Advanced Training: Yes or No

Military: Yes or No

Apprenticeship Program: Yes or No

Occupational Skills Training: Yes or No

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WORK RELATED SKILLS:

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BARRIERS:

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SUPPORTIVE SERVICES NEEDS:

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GOALS:

a. Short Term:

b. Long Term (check required performance measures):

___ Placement in EMP/Training/Education (Q2 Post-exit)

___ Placement in EMP/Training/Education (Q4)

___ Median Earnings

___ Credential Rate

___ Measurable Skills Gain

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Planned Service / WIOA Program Elements. Check the Appropriate activity (*Required Activity):

___*Alternative Secondary School

___*Paid and Unpaid Work Experience

___*Leadership Development Opportunities

___Labor Market/Employment Information

___Supportive Services

___Adult Mentoring

___Comprehensive Guidance and Counseling

___Occupational Skills Training

___Financial Literacy Education

___Entrepreneurial Skills Training

___Post-Secondary Education and Training

___Education offered concurrently with workforce preparation activities and training

___*Follow-Up Services

Participant Concurrence

· I have participated in the preparation of this Individual Service Strategy IEP (ISS)

· I understand and agree with IEP (ISS) program elements established for my participation in the program

· I agree to participate in program activities as assigned by my case manager to achieve program objectives

· I understand WIOA is not an entitlement program, and this ISS does not guarantee receipt of any services

· I understand that this IEP (ISS) and/or information in it may be released to appropriate WIOA and School personnel

· I understand that I have the right to obtain a copy of my IEP (ISS) at any time.

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Participant Signature Age at Program Participation

______

Date

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Case Manager Signature

______

Date SETA 7/1/2016 BH

IEP (ISS) must be reviewed Bi-monthly for WIOA Participants

Case Manager must initial and date upon review

Monthly review: ______