Life Skills Assessment Youth
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- Hillary James
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1 Mostly Life Skills Assessment Youth Date: How old are you? For the next three questions, you will need to ask your CASA Volunteer for help. What is your evaluation ID number? What is your CASA Volunteer s evaluation ID number? What CASA organization does your volunteer work with? Is this a pre-assessment or a follow up assessment? Pre-Assessment Follow-Up Assessment Work and Study Skills Are the following statements like you? I am enrolled in school or a GED program. I have an adult in my life who cares about how I am doing at school or work. I plan to attend college or a vocational school. I have access to transportation to get to work or school. I know the steps I need to take to get a driver s license. I have a driver s license. I know where I can get tutoring or other help with school work. I know how to find financial aid to help pay for my education or training. I have talked about my education plans with an adult who cares about me. I know how to get the documents I need for school or work, such as my Social Security card, birth certificate, and proof of child welfare involvement. I know what type (college, trade school) education I need for the work I want to do. I know how to develop a resume. I have a resume. I know at least two people I can use for references for a job. I know how to fill out a job application. I know how to prepare for a job interview. I know what clothes I should wear to an interview. I have been involved in volunteer service or an internship. I can fill out a W-4 payroll exemption form when I get a job Life Skills Assessment Youth Version rev
2 Mostly I know the steps I need to take to open a checking and/or savings account. I have a checking and/or savings account. I know where I can get help with an income tax form. I get to school or work on time. I can take criticism and direction at school or work without losing my temper. I get my work done and turned in on time. I know at least one adult, other than my worker, who would take my call in the middle of the night if I had an emergency. Self Care Are the following statements like you? I have access to a computer and/or the internet. I know how to use my account. I have a telephone number/cell phone. There is at least one adult I trust who would be legally allowed to make medical decisions for me and advocate for me if I was unable to speak for myself. I know the signs of an abusive relationship. I know the signs of people bullying me online. My relationships are free from hitting, slapping, shoving, being made fun of, or name calling. I know how to do my own laundry. I keep my living space clean. I know the products to use when cleaning the bathroom and kitchen. I have a place to go when I feel unsafe. I know an adult I could live with for a few days or weeks if I needed to. I can make meals with or without using a recipe. I bathe (wash up) daily. I can take care of my own minor injuries and illnesses. I brush my teeth daily. I know how to get health insurance when I am older than 18. I know where to find a doctor or dentist. I know when I should go to the emergency room instead of the doctor s office. I know ways to protect myself from sexually transmitted diseases (STDs) Life Skills Assessment Youth Version rev
3 Mostly I know how to prevent getting pregnant or getting someone else pregnant. I know where to go to get information on sex or pregnancy. I know how to get the benefits I am eligible for, such as Social Security, Medicaid, Temporary Assistance for Needy Families (TANF), and Education and Training Vouchers (ETV). Social Support Are the following statements like you? An adult I trust, other than my worker, checks in with me regularly. I have at least one trusted adult who would visit me if I were in the hospital. I know at least one adult I can depend on when I exit care. I know an adult who could act like a grandparent, aunt or uncle to my children now or my future children. I have friends I like who help me feel valued and worthwhile. I have friends or family to spend time with. I am a part of a family and we care about each other. I can get in touch with at least one family member when I want to. I show others that I care about them. I have a good relationship with a trusted adult I like and respect. I believe my relationships with others will help me succeed. I feel I am ready for the next phase of my life. Most days, I am proud of the way I am living my life. Most days, I feel I have control of how my life will turn out. There is at least one adult that I have regular contact with, other than my case manager or other professional, who lives in stable and safe housing. Don t Forget!!! Even if you complete the assessment on paper, the answers still need to be entered online! If the answers are not entered online, the information will not be provided to National CASA. You can enter the answers online using the following link: Life Skills Assessment Youth Version rev
4 Mostly Don t Know Life Skills Assessment Volunteer Date: How old is the youth with whom you work? What is the YOUTH S evaluation ID number? (If you re not sure, contact your supervisor) What is YOUR evaluation ID number? (If you re not sure, contact your supervisor) What CASA organization do you work with? Is this a pre-assessment or a follow up assessment? Pre-Assessment Follow-Up Assessment Work and Study Skills Are the following statements like the youth with whom you work? I am enrolled in school or a GED program. I have an adult in my life who cares about how I am doing at school or work. I plan to attend college or a vocational school. I have access to transportation to get to work or school. I know the steps I need to take to get a driver s license. I have a driver s license. I know where I can get tutoring or other help with school work. I know how to find financial aid to help pay for my education or training. I have talked about my education plans with an adult who cares about me. I know how to get the documents I need for school or work, such as my Social Security card, birth certificate, and proof of child welfare involvement. I know what type (college, trade school) education I need for the work I want to do. I know how to develop a resume. I have a resume. I know at least two people I can use for references for a job. I know how to fill out a job application. I know how to prepare for a job interview. I know what clothes I should wear to an interview. I have been involved in volunteer service or an internship. I can fill out a W-4 payroll exemption form when I get a job. Life Skills Assessment Volunteer Version rev
5 Mostly Don t Know I know the steps I need to take to open a checking and/or savings account. I have a checking and/or savings account. I know where I can get help with an income tax form. I get to school or work on time. I can take criticism and direction at school or work without losing my temper. I get my work done and turned in on time. I know at least one adult, other than my worker, who would take my call in the middle of the night if I had an emergency. Self Care Are the following statements like the youth with whom you work? I have access to a computer and/or the internet. I know how to use my account. I have a telephone number/cell phone. There is at least one adult I trust who would be legally allowed to make medical decisions for me and advocate for me if I was unable to speak for myself. I know the signs of an abusive relationship. I know the signs of people bullying me online. My relationships are free from hitting, slapping, shoving, being made fun of, or name calling. I know how to do my own laundry. I keep my living space clean. I know the products to use when cleaning the bathroom and kitchen. I have a place to go when I feel unsafe. I know an adult I could live with for a few days or weeks if I needed to. I can make meals with or without using a recipe. I bathe (wash up) daily. I can take care of my own minor injuries and illnesses. I brush my teeth daily. I know how to get health insurance when I am older than 18. I know where to find a doctor or dentist. I know when I should go to the emergency room instead of the doctor s office. Life Skills Assessment Volunteer Version rev
6 Mostly Don t Know I know ways to protect myself from sexually transmitted diseases (STDs). I know how to prevent getting pregnant or getting someone else pregnant. I know where to go to get information on sex or pregnancy. I know how to get the benefits I am eligible for, such as Social Security, Medicaid, Temporary Assistance for Needy Families (TANF), and Education and Training Vouchers (ETV). Social Support Are the following statements like the youth with whom you work? An adult I trust, other than my worker, checks in with me regularly. I have at least one trusted adult who would visit me if I were in the hospital. I know at least one adult I can depend on when I exit care. I know an adult who could act like a grandparent, aunt or uncle to my children now or my future children. I have friends I like who help me feel valued and worthwhile. I have friends or family to spend time with. I am a part of a family and we care about each other. I can get in touch with at least one family member when I want to. I show others that I care about them. I have a good relationship with a trusted adult I like and respect. I believe my relationships with others will help me succeed. I feel I am ready for the next phase of my life. Most days, I am proud of the way I am living my life. Most days, I feel I have control of how my life will turn out. There is at least one adult that I have regular contact with, other than my case manager or other professional, who lives in stable and safe housing. Don t Forget!!! Even if you complete the assessment on paper, the answers still need to be entered online! If the answers are not entered online, the information will not be provided to National CASA. You can enter the answers online using the following link: Life Skills Assessment Volunteer Version rev
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