HN330 Unit 9 DBP
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HN330_IndividualServicePlanAssignmentUnit7.docxHN330: Individualized Service Plan Form Page | 1
Course: HN330
Individualized Service Plan Form
Client Name: Bo
Date of Birth: 10/05/1980
Next of Kin: Jojh Mab
Date: 10/8/2017
Review Date: 1/8/2018 (3 months)
Initial Plan: Bo’s supplemental information
Updated Plan: Empowerment and change
Developed with: Bo and his Case Manager, Tammy Egan
Type of Case Management:
Administrative CM
Resource Coordination CM
Intensive CM
Targeted or Blended CM
Case Manager: Tammy Egan
DSM 5 Diagnostic Impression/Provisional Diagnosis: Individual service plan for Bo
Statement of what I envision my life will be like when I achieve my goals:
|
DOMAIN |
STRENGTH/NEED (select one) |
GOAL(S) |
ACTION STEPS |
TARGET DATE(S) |
|
INCOME/FINANCIAL SITUATION |
Saved much for investment. |
To ensure have an investment that will result for study flow of finances. |
Avoid spending on unnecessary things. Have a saving habit. |
6/8/2018 |
|
HOUSING LIVING ARRANGEMENT |
Has personal house which does not pay rent. |
To have a playground and one for the children. |
Buy another place for building a new house. |
6/8/2018 |
|
VOCATIONAL |
Skills for writing reports and consultancy. |
To raise more money for continued support. |
Taking contracts and doing them diligently. |
10/8/2018 |
|
EDUCATIONAL |
Attained an MBA and a PHD in business. |
Come up with innovation and support business ideas. |
Taking scholarships for payment of fees. |
1/1/2019 |
|
TRANSPORTATION |
Own personal vehicles that make movement easy. |
Ensure efficiency in movement. |
Regular servicing of the vehicles and disposing the old ones. |
1/3/2018 |
|
MEDICAL |
Currently not diagnosed of any illness for 5 years now. |
Continue living a healthy life. |
Eating a balanced diet and doing exercise. |
1/7/2018 |
|
ACTIVITIES OF DAILY LIVING |
Sports |
To train oneself in a responsible manner. |
Training on daily routine. |
1/1/2018 |
|
LEGAL |
Right to movement. |
To set up business in any locations. |
Abiding by laws of the land. |
6/8/2018 |
|
RECREATION & LEISURE TIME |
Swimming |
Relax mind to avoid depression. |
Saving time for recreation. |
6/8/2018 |
|
MENTAL HEALTH |
Free from stress |
To meet daily routine. |
Remaining positive in any situation. |
10/8/2018 |
|
SUBSTANCE ABUSE |
Doesn’t use any drug. |
Ensure healthy living. |
Being aware of effects of substance abuse. |
6/8/2018 |
|
FAMILY RELATIONSHIPS |
Good. |
Teamwork and corporation. |
Holding meetings frequently. |
6/8/2018 |
|
SPIRITUAL |
Born again. |
Ensure integrity and transparency in dealings. |
Attending services and reading spiritual books. |
6/8/2018 |
|
SOCIAL SUPPORTS |
Willing to provide social services. |
Ensure eradication of poverty. |
Teaching people on importance of support. |
2/8/2018 |
|
OTHER |
Still young hence can explore opportunities. |
Development of oneself. |
Identifying available opportunities. |
10/8/2018 |
Client Signature: Bo
Date: 10/8/2017
Legal Guardian’s Signature (if one is assigned or if client is under 18): N/A
Date: 10/8/2017
Case Manager Signature: Tammy Egan
Date: 10/8/2017
Supervisor Signature: Elizabeth Enjilon, LCSW (Licensed Clinical Social Worker)
Date: 10/8/2017
Instructor Feedback:
HN330
:
Individualized Service Plan Form
Page
|
1
Course: HN330
Individualized Service Plan Form
Client
Name:
Bo
Date of Birth:
10/05/1980
Next of Kin:
Jojh Mab
Date
:
10/8/2017
Review Date:
1/8/2018 (3 months)
Initial Plan:
Bo’
s supplemental information
Updated Plan:
Empowerment and change
Developed with:
Bo and his Case Manager, Tammy Egan
HN330: Individualized Service Plan Form
Page | 1
Course: HN330
Individualized Service Plan Form
Client Name: Bo
Date of Birth: 10/05/1980
Next of Kin: Jojh Mab
Date: 10/8/2017
Review Date: 1/8/2018 (3 months)
Initial Plan: Bo’s supplemental information
Updated Plan: Empowerment and change
Developed with: Bo and his Case Manager, Tammy Egan
