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Code: PS. Personal & Social Setting Adjustment
Code: S. Sexuality
Code: HH. Health & Hygiene
Code: S-S. Survival skills
Code: CR. Community Resources
Code: HS. Home Safety
Code: C. Communication
Code: RR. Reading and Writing
Code: LT. Leisure Time
Code: M. Mobility
Code:PV. Prevocational
Code: TM. Time Management
Code: A. Arithmetic
Code: MM. Money Management
This section of the assessment identifies every aspect of Health
and Hygiene in six categories:
A. Toileting
C. Grooming
D. Dressing
E. Exercise
F. Wellness
Code: HL. Home Living Skills
This section of the assessment identifies various aspects of
communication and speech in two categories:
A.  Verbal Communication
B.  Non-Verbal Communication
This section of the assessment identifies various aspects of home
living  in the following categories:
A. Living Room
B.  Kitchen (Cooking)
C.  Kitchen (Cleaning)
D.  Bedroom
E.  Bath And Utility Room
F.  Travel Skills
G. Custodial Skills
H. Laundry
I.  Temperature setting
This section of the assessment identifies various aspects of
successful interactions with others in nine categories:
A.  Verbal skills
B.  Paraverbal skills
C.  None verbal skills
D.  Emotional skills
E.  Identifies own personality
F.  Listening skills
G.  Respond skills
H.  Social attire skills
I.   Participation preferences
This section of the assessment identifies various aspects of
Prevocational skills in ten categories:
A. Appearance
B.  Ethics
C.  Quality
D. Time Management
E.  Dispute Resolution
F.  Social interactions
G. Self management
H. Job application skills
I.  Computer skills
J.  Interview skills
This section of the assessment identifies various aspect of community
survival skills in ten categories:

A.  Identifies various natural disasters
B.   Identifies natural disaster procedures
C.   Identifies man-made disasters
D.  Follows man-made disaster instructions
E.  Participates in disaster drills
F.  Identifies emergency situations
G.  Distinguish between various emergencies
H.  Utilize communication device to make emergency contacts
I .  Community signs and landmarks
J .  Personal information
This section of the assessment identifies various aspect of
sexuality in nine categories:

A.  Identifies various aspects of sexuality
B.  Knows sexual preference
C.  Distinguish relationships
D.  Is or has been sexually active
E.  Sexual vocabulary
F.  Deals with sexual impulse
G.   Identifies the process of sexual reproduction
This section of the assessment identifies various aspect of home
safety skills in nine categories:

A.  Distinguish between different electrical outlets
B.  Identifies the function of fuse box
C.  Skills to answer door
D.  Lock and secures environment
E.  Kitchen safety
F.  Emergency numbers
G.  Communicate state of emergency
H.  Knowledge to evacuate
I.   Designated natural disaster area
This section of the assessment identifies various aspect of
community resources in ten categories:

A.  Medical resources/ Health Department
B.  Emergency medical resources
C.  Social services resources
D.  Police emergency services
E.  Utilities emergency services
F.  Shelter services
G.  Community access resources Library
H.  Transportation resources
I.  Accessing community
J.  Recreational resources
Code: SM. Sensorimotor
Code: B. Behavioral  
This section of the assessment identifies various aspect of
behavioral issues in eleven categories:

A.  
Disruptive
B.  Runs/Hides
C.  
Confrontational/Intimidation
D.  Oppositional
E.  Verbal abuse/Verbal Rage/Questions authority
G.   Property destruction
H.   Physical aggression
I.  Autism spectrum (ASD)
This section of the assessment identifies various aspect of mobility
in four categories:

A.  Public transportation choices
B.  Mapping choices
C.  Private vehicle
D.  Handicapped access
This section of the assessment identifies various aspect of leisure
time in six categories:

A.  
Leisure planing
B.  Indoor leisure activities
C.  Outdoor leisure activities
D.  Hobbies
E.  Computer skills
F.  Senior oriented activities
This section of the assessment identifies various aspect of money
management in five categories:

A.  Coin and bills recognition
B.  Budgeting/pay bills
C.  Bank accounts
D.  Purchasing
E.  Money smart
This section of the assessment identifies various aspect of reading
and writing in seven categories:

A.  Basic reading and comprehension
B.  Intermediate reading and comprehension
C.  Advanced reading and comprehension
D.  Basic writing
E.  Intermediate writing
F.  Advanced writing
G.  Braille
This section of the assessment identifies various aspect of time
management in six categories:

A.  Tells time
B.  Uses association to tell approximate time
C.  Follows a routine for time management
D.  Identifies seasonal and calender events
E.  Identifies daily events
F.  Set clock
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Consumer name:                                                                                 Date:

Evaluator (print):                                                  Signature:
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This section of the assessment identifies various aspect of
arithmetic issues in eleven categories:

A.  
Count from 1-100
B.  Count by 5's to 100
C.  Count by 10's to 100
D.  Add digits
E.  Subtract digits
F.  Multiply digits
G.  Divide digits
H.  A-G: Uses calculator
I.   Measures in inches
J.  Measures in feet
K. Measures in yard
L. Measures in centimeter
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This section of the assessment identifies various aspects of
sensorimotor issues in thirteen categories:

A.  Roll a basketball size
B.  Catch a basketball size
C.  Bounce a ball to others
D.  Close a door
E.  Open a door
F.  Pedal a tricycle or bike with training wheels
G.  Pedal a two wheeled bike
H.  Exercise in a group
I.   String beads
J.   Lace a string through a card
K.  Go up and down stairs
L.  Use scissors
M.  Use a seat belt
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