Personal Care Support Plan
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Personal Care Assistance Service Support Plan Sheltered Workshop: Employee’s Name: Employee’s SSN: List of who attended the individual’s personal care assistance meeting: Indicate documentation clearly stating the need for personal care support: Is a Person Centered Plan Available - Yes No (Attach copy of all documentation supporting need to this plan.) 1) What Personal Care Assistance/support is required for the consumer to be successfully employed Personal Care Assistance Plan Page 2 Personal Care Assistance Plan for: 2) Intensity/Duration of supports: (Estimated amount of time and when supports will be provided)
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