"Elp Personal Profile Form" - Delaware

This fillable "Elp Personal Profile Form" is a document issued by the Delaware Health and Social Services specifically for Delaware residents.

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Download "Elp Personal Profile Form" - Delaware

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DELAWARE DIVISION OF DEVELOPMENTAL DISABILITIES
ELP Personal Profile
This document is meant to provide a clear, easy-to-understand picture of a person and
their supports. Please complete each section about the person to the best of your
knowledge.
NAME:
PERSON COMPLETING PROFILE:
OTHERS CONTRIBUTING INFORMATION:
COMPLETION DATE:
NOTE: This ELP PERSONAL PROFILE should be completed by anyone who knows
the person and who has information about how the person wants to live or wants to be
supported. This profile is especially useful for getting information from people who are
unable to attend the annual meeting or otherwise meet with the facilitator.
Section 1: What people like and admire about __________
Section 2: Describe what is important to
in Day Services.
A.
Places that
likes to go:
B.
Activities/Hobbies that
enjoys doing:
C.
Work/Volunteering/Help that
enjoys doing:
D.
People that are important to
at the Center:
DELAWARE DIVISION OF DEVELOPMENTAL DISABILITIES
ELP Personal Profile
This document is meant to provide a clear, easy-to-understand picture of a person and
their supports. Please complete each section about the person to the best of your
knowledge.
NAME:
PERSON COMPLETING PROFILE:
OTHERS CONTRIBUTING INFORMATION:
COMPLETION DATE:
NOTE: This ELP PERSONAL PROFILE should be completed by anyone who knows
the person and who has information about how the person wants to live or wants to be
supported. This profile is especially useful for getting information from people who are
unable to attend the annual meeting or otherwise meet with the facilitator.
Section 1: What people like and admire about __________
Section 2: Describe what is important to
in Day Services.
A.
Places that
likes to go:
B.
Activities/Hobbies that
enjoys doing:
C.
Work/Volunteering/Help that
enjoys doing:
D.
People that are important to
at the Center:
Section 3: Describe what is important for
‘s success on a job.
*Does
like his/her current job?
*Did
choose his/her job?
A.
Places that
would like to work:
[including business names and town/location]
B.
Hours/Days that would be most desirable:
C.
Working alone or in groups...does it matter?
D.
Types of work that
is interested in:
E.
Types of work that
dislikes:
F.
Things that _________ MUST HAVE that might affect work:
Section 4: Describe what is important to
at home.
A.
Places that
likes to go:
B.
Things that
enjoys doing:
1.
At home:
2.
While we are out:
C.
Chores/responsibilities, around the house, that
enjoys doing:
D.
People at home that are important to
:
E.
Things that
really dislikes:
F.
‘s HOPES and DREAMS:
G.
Important routines such as:
1.
Morning
2.
During transition
3.
Coming home
4.
Holidays/Celebrations
5.
Other
H.
Things that can ruin ____________________’s day.
I.
Things that can make a great day for ___________________.
J.
Other things important to the person:
Section 5: Describe the best way(s) to help ____________________ learn.
(Use “Identifying a Person’s Learning Style” to complete this section.)
Section 6: Things to try or learn
A.
Things they tried and enjoyed this past year:
B.
Ideas for this year:
Section 7: Communication: (Must be completed if a person does not talk.)
A.
How do you know
likes something?
B.
How do you know
dislikes something?
C.
Other important information regarding how
communicates:
D.
Other important information regarding how we communicate with
_____________.
E.
Communication Table
In this situation:
When
We think it means
You should do this:
does this:
this:
Section 8:
Progress and Significant Events of the past year:
Section 9: In Order to Support
, we must:
A.
During Meals:
1. At home:
2. When we are out:
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