JDFS Entry Form

Please enter the information from your Job Development Fidelity Scale in the fields below. When you are finished, click on the Submit button at the bottom of the screen.

Navigation Instructions: Press TAB to advance to a new form field. Press SHIFT + TAB to return to a previous field. In drop-down fields, press DOWN ARROW to cycle through the available options. Press ENTER or TAB to select an option. Once you have selected an option, press TAB again to advance to the next field.

When you reach the end of the form, press TAB to select the Submit button, and hit ENTER to submit the form. (The Submit button is not selectable unless every required field has been filled.)

JDFS Administrator Information

JDFS Administrator Name*

Email*

Agency*

Select or enter value

Years in Field*

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State*

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Date*

JDFS Submitted*

Select

Row ID of Previous Submission

JDSR Upload

Upload a de-identified copy of the JDSR you are scoring.

Drag and drop files here or

Employment Specialist Information

Years Providing CE Services

For how many years has the Employment Specialist provided Customized Employment Services?

Select or enter value

Training Received

List any employment services or employment services-related training the Employment Specialist has received.

Mentoring Received

List any mentoring the Employment Specialist has received.

Number of Individuals Support with CE

For how many other individuals has the Employment Specialist Provided CE services?

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Employment Seeker Information

Employment Seeker's Primary Disability

Employment Seeker's Age

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Employment Seeker's Gender

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Employment Seeker's Ethnicity

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What agency funded Customized Job Development?

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IPE Status

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HCBS Waiver Status

Does the Employment Seeker have an HCBS (Home and Community-Based Services) Waiver?

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List any other services the employment seeker receives.

Job Development Systems Tenet 1.1*

Customized Job Development is based on the Discovery Employment Plan.

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Job Development Systems Tenet 1.2*

Customized Job Development is based on dedicated financing to provide different services than traditional job development services.

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Job Development Systems Tenet 1.3*

The customized job developer or a qualified person provides Customized Job Development.

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Job Development Systems Tenet 1.4*

The agency delivering Customized Job Development services ensures relationships, based on the Discovery Plan, between the employment seeker and community members.

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Job Development Systems Tenet 1.5*

The Employment Seeker, utilizing Customized Job Development services, has accessible and reliable transportation services and financing.

Select

Job Development Services Tenet 2.1*

The customized job developer and the employment seeker decide which of the positive skills, assets, supports, information, pictures or videos, learned or developed during Discovery, will be shared with employers and, if applicable, used to develop small business ownership.

Select

Job Development Services Tenet 2.2*

The customized job developer assists the employment seeker develop employment that meets the expectations of the Financial Plan developed during Discovery that includes goals and resources, information from a benefits planner, and if applicable, plans to ensure the financial success of employment seeker’s own business.

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Job Development Services Tenet 2.3*

The customized job developer and the employment seeker work together developing employment that meets the ideal number of hours of work each week and the number of hours of non-work services and supports.

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Job Development Services Tenet 2.4*

The customized job developer and the employment seeker meet with businesses to identify a fit between the workplace culture, tasks, skills, and the employment seeker’s ideal conditions for employment.

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Job Development Services Tenet 2.5*

The customized job developer, always with the employment seeker when possible, conduct informational interviews with businesses.

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Job Development Services Tenet 2.6*

The customized job developer completes formal analyses of job tasks, skills, coworker supports, and employee training.

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Job Development Services Tenet 2.7*

The customized job developer negotiates a mutually beneficial economic win-win proposal, between the employment seeker and the business, or when applicable, a self-employment proposal.

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Job Development Services Tenet 2.8*

The customized job developer creates a job site training plan, detailing job tasks, required skills, new skill development, training, and support strategies for the employer.

Select

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