Form 9.1.1 "Child and Family Teams Proficiency Measurement Tool for Facilitation" - Arizona

What Is Form 9.1.1?

This is a legal form that was released by the Arizona Department of Health Services - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 15, 2007;
  • The latest edition provided by the Arizona Department of Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 9.1.1 by clicking the link below or browse more documents and templates provided by the Arizona Department of Health Services.

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Download Form 9.1.1 "Child and Family Teams Proficiency Measurement Tool for Facilitation" - Arizona

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Form 9.1.1
Arizona Child and Family Teams Proficiency Measurement Tool for Facilitation
Arizona Principle
Rating: Score 1 - 5 for each data source used - see User Guide Pg. 2
Overall Rating for Each Skill
Targeted Skills:
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Collaboration with Child
1. Demonstrating active listening
and Family
2. Negotiating agreement on work to be done togethe
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
2. Functional Outcomes
1. Identifying needs
2. Service planning process builds on identified needs
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
3. Collaboration with
1. Building consensus with the team
Others
2. Communicating effectively with team members
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
4. Accessible Services
1. Creative problem-solving to meet identified needs
2. Actively working to identify and resolve barriers
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Seeking opportunities to increase knowledge base of the child
5. Best Practices
and family team to meet specialized needs
2. Demonstrating ability to evaluate and modify services if
needed.
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Identifying resources and supports available to keep children
6. Most Appropriate Setting
in their home and community
2. Exploring reasonable alternatives before considering placing
children in out of home setting
Strengths (what's working)
Next Steps to Improve
Proficiency
Page 1 of 4
ADHS 7/15/07
Form 9.1.1
Arizona Child and Family Teams Proficiency Measurement Tool for Facilitation
Arizona Principle
Rating: Score 1 - 5 for each data source used - see User Guide Pg. 2
Overall Rating for Each Skill
Targeted Skills:
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Collaboration with Child
1. Demonstrating active listening
and Family
2. Negotiating agreement on work to be done togethe
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
2. Functional Outcomes
1. Identifying needs
2. Service planning process builds on identified needs
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
3. Collaboration with
1. Building consensus with the team
Others
2. Communicating effectively with team members
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
4. Accessible Services
1. Creative problem-solving to meet identified needs
2. Actively working to identify and resolve barriers
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Seeking opportunities to increase knowledge base of the child
5. Best Practices
and family team to meet specialized needs
2. Demonstrating ability to evaluate and modify services if
needed.
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Identifying resources and supports available to keep children
6. Most Appropriate Setting
in their home and community
2. Exploring reasonable alternatives before considering placing
children in out of home setting
Strengths (what's working)
Next Steps to Improve
Proficiency
Page 1 of 4
ADHS 7/15/07
Form 9.1.1
Arizona Child and Family Teams Proficiency Measurement Tool for Facilitation
Facilitator: _______________________________________________________
Supervisor: _______________________________________________________ Date: _____________________________
Page 2 of 4
ADHS 7/15/07
Form 9.1.1
Arizona Child and Family Teams Proficiency Measurement Tool for Facilitation
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
7. Timeliness
1. Following-up on assigned tasks promptly.
2. Communication with team members is timely
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Listening to and respecting the preferences of the child and
8. Services Tailored to the Child
family.
and Family
2. Actively encouraging family and youth involvement in the CFT
process.
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Recognizing when a child may be at risk of experiencing a
placement disruption (may be a living situation or school setting
9. Stability
or other social/familial) and incorporating steps in the service
plan to minimize the risk
2. Anticipating and planning for transitions in the lives of the
child and family (new school, etc.)
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
10. Respect for the child
1. Interviewing families with respect, curiosity and persistence
and family's unique cultural
heritage
2. Listens in a non-judgmental way
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
1. Identifying any support and/or training needed for the
11. Independence
parent(s)/guardian(s) or child to meet behavioral health needs
2. Procuring or providing resources for identified support and
training.
Strengths (what's working)
Next Steps to Improve
Proficiency
Targeted Skills
Self
Observation
Family Feedback
Chart Review
Summary Skill Rating
12. Connection to Natural
1. Engaging with families and discovering untapped resources.
Supports
2. Involving natural supports in the team process.
Strengths (what's working)
Next Steps to Improve
Page 3 of 4
ADHS 7/15/07
Form 9.1.1
Arizona Child and Family Teams Proficiency Measurement Tool for Facilitation
Proficiency
Page 4 of 4
ADHS 7/15/07
Page of 4