Community+Events


 * COMMUNITY ASSESSMENT **
 * Dates of Assessment _______________________Complied by _____________________________**


 * City/County/Community______________________________________________________________**

The headings in **//Community Assessment//** are aligned with postsecondary outcomes specified in the definition of transition services from IDEA 2004. In addition, transportation is included to encourage optimal independence for students with disabilities

Student Identification Information

Name: ___________________________________________________________________________

Telephone(s): ___________________________________________________________________________

___________________________________________________________________________

Email: ___________________________________________________________________________

Address : ___________________________________________________________________________

___________________________________________________________________________

Postsecondary Goals:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

**(**List organizations, services/activities, Website/telephone) **1A. Recreational Resources** Parks and Recreation Services YMCA, Gym Facilities Community Theatres/Arts Facilities Museums, Local Attractions Movie Theatres Libraries Other **1B. Religious Resources (**List organizations and services and Website or Telephone) **1C. Consumer Resources** (List organizations/businesses and services and Website or Telephone) Medical Services Health Services Social Services Grocery Stores, Banks Other **__ 2. Services for Individuals with Disabilities __** (State and/or Local name, services, Website/ telephone, address) **2A. Vocational Rehabilitation** **2B. Developmental Disabilities** ** 2C. Mental Health Services** **2D. Social Security Benefits Office** **2E. Local Adult Service Providers (Not for Profit Agencies)** **2F. Other** **__ 3. Employment Resources __** (List organization/business, type of services, contact information, Website/telephone)
 * 1) **__ Community Resources __**


 * 3A. Sources for Job Openings**

One-Stop Career Center

Local Newspapers

Websites for Community or State Listings

Employment offices

Vocational Rehabilitation

Secondary work-study teachers


 * 3B. Examples of Businesses within a 5-mile radius of the student's home**


 * 3C. Community Adult Service Providers**:

Which of the adult service providers (Identified in 2E) fund individual job coaching?

Which of the adult service providers (Identified in 2E) fund supported employment?

Which of the adult service providers (Identified in 2E) fund day habilitation programs?

**__ 4. Postsecondary Education, Vocational Education, Adult and Continuing Education __**

(Local School System) || || ||
 * ** Type ** || ** Programs/Activities ** || ** Website or Telephone ** ||
 * 4a. Programs or Services for Students Ages 18-21 Funded by Local School Systems || || ||
 * 4b. Community College || || ||
 * 4c. Colleges or Universities || || ||
 * 4d. Continuing Education
 * 4e. Continuing Education (Community College) || || ||
 * 4f. Public Career-Technical Schools || || ||
 * 4g. Private Career-Technical Schools || || ||
 * 4h. Apprenticeship Programs || || ||
 * 4i. Other || || ||

**__ 5. Independent Living __**

(List name or organization that provides residential services in the and website/telephone)


 * 5A. Agencies**

Social Services

Department of Housing

Developmental Disabilities

State Medicaid Waivers

Other:


 * 5B. Which of the adult service providers** (Identified in 2E) provide residential options or services to support individuals with disabilities to live independently?

**__ 6. Transportation Information __** What type of transportation is available to employment and community resources? __ Start your search on the Internet __. Using Google, type city, county, or state and special transportation (also try Para transit or specialized transportation for people with disabilities). ** Useful Websites: ** (If public transportation is available, please attach appropriate schedule.) (State/county government) ||  ||   ||   ||   || How does the student access special services and or fares? __________________________________________________________________________________________________________________________ ____________________________________________________________________________________ Voucher Programs ||
 * 6A. Public Transportation (attach appropriate information) **
 * Bus || Yes || No || Website or Telephone Number || Special Fare? Vouchers? ||
 * Subway ||  ||   ||   ||   ||
 * Light Rail ||  ||   ||   ||   ||
 * Special Public Bus || ||  ||   ||   ||
 * Special Public Van ||  ||   ||   ||   ||
 * Para transit Options
 * 6B. Taxi Service**
 * Company || Telephone number || Accommodations or Special Services

How does the student access special services and or fares?_ __________________________________________________________________________________________________________________________ ____________________________________________________________________________________
 * 6C. Other Transportation Services** (e.g., Carpools)