Diverse Learning Shift notes and time sheet
Staff Member Name
*
Geolocation
Date worked (If shift went past midnight please enter the date you STARTED the shift)
*
-
Day
-
Month
Year
Date Picker Icon
Day of the week (if overnight please choose the day the shift started)
*
Please Select
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Time *NOTE 24 HOUR CLOCK TIMES* eg 1pm =13:00
*
Hour Minutes
until
Hour Minutes
Total 0.0
Break time taken during shift
Enter any parts of hours in quarter hour blocks eg 15 minutes = 0.25, 30 min = .0.5; 45 minutes= 0.75
Type of work completed (as agreed to by client service agreement or Employment contract)
*
Support work- including community, in home and supported employment
Supported employee/SLES allowance
LEVEL 2 therapy assistance
SLES(billed from SLES funding only - NOT SUPORTED employment/Finding Keeping a job)
Support Coordination
Therapy (CB Daily or Social)
Psychosocial Supports
Behaviour Practitioner
Programs
Admin as per approved role
Staff meeting (up to 1.5 hours)
CLAIM TOIL
CLAIM Personal Leave (sick, compassionate, Carer's)
CLAIM Annual Leave
Other (eg Public Holiday)
Type of SLES support delivered
*
Assessments
Planning and reviewing progress
Exploring employment options
Engagement with family/carer to support employment directions
Engagement with other professionals/providers to support employment goals
Building social, presentation and communication skills
Travel training
Work skills training
Employer engagement, education and job customization.
Work experience support (on the job)
On the job support when initially employed
Other activity
Progress towards selected SLES milestone.
*
Type of support:
*
In home supports (minimum 2 hours)
Supports in community
Overnight supports
Support during Supported employment (billed as core/access community participation)
Supports during respite/short term accommodation (please add overnight supports also if applicable)
Supports Funded as Higher Intensity Supports
On call allowance
Remote- 15 min
Accessing community - Shift cancellation
Finding and keeping a job item 10_016_0102_5_3 Employment assistance $77
Bill for Centre/Capital cost (yes if services delivered at Kerry St - in person times only).
*
Yes
NO
Amount of time Centre capital cost to be bill (in hours - eg 1.25 hours =1 hour 15 minutes)
Ratio of support delivered
Individual 1:1
1:2
1:3
Existing Client name/s
*
2nd Existing Client name/s
*
3rd Existing Client name/s
*
New Client (not listed in Drop-down box above)
Rows
Further info
Name of client
Management type (agency/plan/self) and invoicing email address:
NDIS no
Service agreement signed Yes/No
Email address for invoicing
Program Name
*
Magic Mondays
The Mix South
Lego South
The Mix North
Lego North
Esensual Health
Chill N Grow
Other
What type of program task?
Facilitating
Planning and admin
Training
Type of Support Coordination
*
Level 1 - Support Connection
Level 2 - Support Coordination
Level 3 - Specialist Support Coordination
Are there any changes to any of your Client’s plan or details?
Please list changes here, including new plans, new service agreement, contact details etc
*
Type of therapy
DE
Early Childhood Intervention
Counselling
Other Therapies
CB Social Community and Civic participation - Therapy $193.99
Skill development and training including public transport training
‘Finding and keeping a job’ employment assessment and therapy item 10_011_0128_5_3
'Life transition planning NDIS support item 09_006_0106_6_3
Life Transition Planning 09_006_0106_6_3
Other
Type of Behaviour support
*
Specialist Behaviour Support
Behaviour Management Plan Development and Training
Skills Development
Number of hours in a passive shift
How many out of the 8 hours passive overnight shift were ACTIVE hours (ie required to attend ACTIVELY to the clients needs.
*
Number of passive hours worked
Total active hours worked
Did you transport the client? if so how many km.
Did you travel more than 15 minutes to the client? If so how much travel time? Maximum of 30 minutes
Did you travel from one Diverse Learning work location/program location to another to or from the program? if so how many km?
Shift/Case notes - Please record here UNLESS another system is in place for this client/service which you have already completed
Tasks completed during shift
*
Community and social support
Emotional Support
Support during an appointment
Assistance to manage routins
in home supports
Domestic assistance (Cleaning)
Supports during employment, or skill building for employment
Other
Observed mood
*
Disengaged
Engaged
Anxious
Calm
Angry
Distressed
Happy
Excited
Other
Is an incident report required
*
Yes
No
Shift Summary - what happened during shift today, include locations, any extra supports needed, wins, gains.
*
Safety concerns (in any)
any other info
Email
*OPTIONAL- if you would like to be sent a copy of your submission
Submit
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