Literacy and Basic Skills Exit and Follow-Up€¦ · Title: Literacy and Basic Skills Exit and...

1788E (2019/05) © Queen's Printer for Ontario, 2019 Disponible en français Page 1 of 6

Ministry of Training, Colleges and Universities

Literacy and Basic Skills Exit and Follow-Up

Service Provider Use OnlyCase Reference Person Reference

Name and Contact InformationLast Name First Name Middle Initial

AddressUnit Number Street Number Street Name PO Box

City/Town Province Postal Code

Primary Phone NumberHome Mobile Other

Telephone Numberext.

Alternate Phone NumberHome Mobile Other

Telephone Numberext.

Email Address

Outcome at ExitReviewer Actual Start Date (DD/MM/YYYY)

Details

Reason for Closure

Change of Goal

Client Deceased

Client Moved

Client Started a Business

Completion

Found Work Related to Goal

Found Work Unrelated to Goal

Left Labour Force

Opened in Error

Other

Personal Reasons

Program Unsuitable

Training Provider Closed

Unable to Contact Client

Unsatisfactory Training Provider

Service Provider Closed

Customer SatisfactionOn a Scale of 1 to 5, how likely are you to recommend the LBS Program to someone looking for similar services?

1 – strongly not recommended 2 – rather not recommend 3 – no general opinion 4 – generally recommend

5 – strongly recommend No Response – Client did not respond to survey

Answer the following questions by selecting one of the provided optionsAs a result of participating in LBS program, your employment situation has improved.

Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree

As a result of participating in LBS program, you are better prepared to find and maintain employment.


As a result of participating in LBS program, you have developed and/or increased skills.


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OutcomeBoth employed and in Education

Both employed and in training

Employed Apprentice

Employed in a more suitable job

Employed in a professional occupation/trade

Employed in area of training/choice

Employed Part-Time

Employed Full-Time

In education – post secondary

In education – OSSD or equivalent

In education – academic upgrading

In education – other

In training – EO Literacy

In training – ESL/FLS

In training – Federal

In training – MCI Bridge projects

In training – Second Career

In training – other EO training initiatives

In training – other occupational skills training

Independent

Self-Employed

Unable to work

Unemployed

Unknown

Volunteer

EmploymentEmployment Type

Paid Placement Hire Self-Employment Unpaid VolunteerCountry of Employment

Employer

Start Date (DD/MM/YYYY) End Date (DD/MM/YYYY) Job Title

Employment Hours Per Week Wage Amount ($) Pay PeriodHour Week Bi-weekly Month Year

NOC NAICS

Comments

In Education or In TrainingInstitution

Qualification TypeFull-Time Part-Time

Start Date (DD/MM/YYYY) End Date (DD/MM/YYYY) Country of Institution

Comments

Assessment

Exit Learner Gains Score:Reading Document Use Numeracy

Date of Exit Assessment (DD/MM/YYYY)

Has the goal path specific Culminating Task been successfully completed?

Yes No No Response

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Has the learner completed all goal path requirements identified in the learner plan?

Yes No No Response

Self Reported Learner Weekly Time Commitment?

Outcome at 3 MonthsReviewer Actual Start Date (DD/MM/YYYY) Completed Date (DD/MM/YYYY)







Outcome

Both employed and in Education Both employed and in training

Employed Apprentice

Employed in a more suitable jobEmployed in a professional occupation/tradeEmployed in area of training/choiceEmployed Part-Time

Employed Full-Time


In education – OSSD or equivalentIn education – academic upgradingIn education – other




In training – MCI Bridge projectsIn training – Second Career

In training – other EO training initiativesIn training – other occupational skills training

Independent

Self-Employed

Unable to work

Unemployed

Unknown

Volunteer



Employer



NOC NAICS

Comments

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Comments








OutcomeBoth employed and in Education Both employed and in training

Employed Apprentice


Employed Full-Time








Independent

Self-Employed

Unable to work

Unemployed

Unknown

Volunteer



Employer



NOC NAICS

Comments

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Comments








Outcome

Both employed and in Education Both employed and in training

Employed Apprentice


Employed Full-Time








Independent

Self-Employed

Unable to work

Unemployed

Unknown

Volunteer



Employer



NOC NAICS

Comments

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Comments

Literacy and Basic Skills Exit and Follow-Up�Name and Contact Information�Outcome at Exit�Details�Assessment�Outcome at 3 Months�Outcome at 6 Months�Outcome at 12 Months�

1788E (2019/05) © Queen's Printer for Ontario, 2019

Disponible en français

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1788E (2019/05)

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Ministry of Training,  Colleges and Universities

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Government of Ontario

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Reason for Closure

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On a Scale of 1 to 5, how likely are you to recommend the LBS Program to someone looking for similar services?

Answer the following questions by selecting one of the provided options

As a result of participating in LBS program, your employment situation has improved.



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Has the learner completed all goal path requirements identified in the learner plan?

Outcome at 3 Months

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Year.: Outcome at 12 Months. Employment. National Occupational Classification. : Outcome at 12 Months. Employment. North American Industry Classification System. : Outcome at 3 Months. Employment. Comments.: Outcome at 12 Months. In Education or In Training. Institution.: Outcome at 6 Months. In Education or In Training. Qualification.: Outcome at 12 Months. In Education or In Training. Type. Full-Time.: Outcome at 12 Months. In Education or In Training. Type. Part-Time.: Outcome at 12 Months. In Education or In Training. Start Date. Enter date in format: day: 2 digits, month: 2 digits, year: 4 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard).: Outcome at 12 Months. In Education or In Training. End Date. Enter date in format: day: 2 digits, month: 2 digits, year: 4 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard).: Outcome at 6 Months. In Education or In Training. Comments.: Assessment. Exit Learner Gains Score: Reading.: Client Summary. Assessment. Exit Learner Gains Score: Document Use.: Client Summary. Assessment. Exit Learner Gains Score: Numeracy.: Assessment. Date of Exit Assessment. Enter date in format: day: 2 digits, month: 2 digits, year: 4 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard). : Assessment. Has the learner completed all goal path requirements identified in the learner plan? Yes.: Assessment. Has the learner completed all goal path requirements identified in the learner plan? No.: Assessment. Has the learner completed all goal path requirements identified in the learner plan? No Response.: Assessment. 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Literacy and Basic Skills Exit and Follow-Up€¦ · Title: Literacy and Basic Skills Exit and...

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