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Internship Manual

CEO Internship Manual Rev 7 - TransCen CEO is a ... 6‐7 Site Assessment ... What sets this experience apart from others is the data collection and performance evalua-tions throughout

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Internship Manual 

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 2

creative employment opportunities

Revolutionizing workforce diversity  

 

 

 

 

 

Table of Contents Introduc on and Descrip on .......................................................................................... 3‐5 

Business Partner Agreement .......................................................................................... 6‐7 

Site Assessment ............................................................................................................ 8‐13 

Sample Site Assessment ............................................................................................. 14‐25 

Intern Criteria and Job Descrip on .................................................................................. 26 

Applica on and Interview Process .............................................................................. 27‐30 

Orienta on and Training .................................................................................................. 31 

Employer Intern Evalua on ........................................................................................ 32‐34 

Agency Intern Evalua on ............................................................................................ 35‐37 

Sample Agency Intern Evalua on ............................................................................... 38‐41 

Notes ............................................................................................................................... 42 

 

 

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 3

creative employment opportunities

Revolutionizing workforce diversity

Introduction

Internships are important for any job seeker – including individuals with disabilities. Because the term “internship” is universal, employers understand the concept and often look for internships on resumes. They provide an opportunity for a job seeker to “test drive” a job to see if they enjoy the ride. In addition, intern-ships allow an employer to “try on” a potential employee.

Internships are a unique opportunity to learn about what a job seeker wants to do and what they do not want to do. Often when someone starts working at their “ideal” job, they realize it is not so ideal for them after all. Not all internships work out – but that does not mean they are not successful. We learn from all our experiences – the good, bad and even the ugly!

All internships teach soft job skills, and every employer is looking for employees with soft job skills (which is why behavioral interviewing and testing is so prevalent today). Most employers rank interpersonal skills, com-munication, intuitive, and teamwork above technical aptitude. There is no better way for job seekers to learn these skills than to jump into a real work environment.

Description

The following is a description for establishing an internship process. There should be two identical binders made containing the sections outlined below. One binder should be kept at the business and one binder should be kept in the office. Depending on the internship, these sections may include more or less infor-mation; and more sections may be added as needed.

Tip: It is important to customize the information to the specific business and intern.

Part One

Partnership Agreement. This agreement can be individualized based on the arrangement with the business and intern. At a minimum, the Partnership Agreement should include roles and responsibilities of both the business partner and agency. The agreement provided in this binder is an example that can be used for future partner-ships.

Tip: Include agency’s Insurance Liability with the specific business listed under “Certificate Holder”

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 4

creative employment opportunities

Revolutionizing workforce diversity

Part Two

Site Assessment. The sample included in this binder includes the information that should be gathered when conducting a business site assessment. With each business, the different sections may include more or less information depending on the needs of potential interns, environment, job analysis, staffing, etc.

Tip: Be sure to include workplace culture information!

Part Three

Intern Criteria and Job Description. This section is critically important and should include the specific quali-ties the business is looking for in their interns and/or employees. The job description could be the standard description the business uses for current employees in that position OR it could be a customized job descrip-tion the agency develops with the business for the internship position.

Tip: When customizing a job description, be sure to look at the current and future needs of the business and match them with the interests of the potential intern.

Part Four

Application and Interview Process. The application process should be individualized based on the business and intern. Depending on the business agreement, the application used by the business can be utilized OR the agency may need to create an application specific to the internship. The interview process should also be indi-vidualized based on the business agreement and intern. When formulating this section, keep in mind the job seekers with whom you are working to ensure that their interests and talents are highlighted.

Tip: Bringing the potential intern to the business for a job shadow is a good idea to include as part of the interview. A hands on interview, photos or video clips of the potential intern are also good tools to use.

Part Five

Orientation and Training. Depending on the business agreement, think about the following questions: 1) Will the intern go through the orientation that hired employees go through or will there be an individualized orien-tation for the intern? (This determination might depend on the assets and barriers of the specific intern)

2) Will there be an agreed upon amount of time for training that is or is not included in the length of the intern-ship?

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 5

creative employment opportunities

Revolutionizing workforce diversity

3) Who will do the training? Ideally, the business should conduct as much of the orientation and training as possible with the agency staff on the side providing support as needed.

Tip: Support does not only apply to the intern but also to co-workers and supervisors. This is a great time to provide education and training to the business staff as well and begin to identify potential “natural” sup-ports on the job.

Part Six

Evaluation Process. What sets this experience apart from others is the data collection and performance evalua-tions throughout the internship. The evaluation process is designed to help determine the intern’s strengths and areas of need, and to determine if the job, work tasks, work environment are a good match for the intern (i.e., Is the intern making progress in learning the job duties? Does the intern enjoy the tasks begin performed? Is the work environment/culture suitable for the intern?). Provided in this guide are general evaluations that should be used at the mid-point (usually around 20 hours) and again at the end (usually around 40 hours) of the internship. It is not uncommon for internships to be extended and additional evaluations should be con-ducted. Depending on the business, it might be more appropriate to adapt the evaluation tool or use the busi-nesses evaluation process.

Tip: At the end of the internship, a final Internship Evaluation Report should be completed by agency staff to summarize all the evaluations and guide plans for future job development.

Part Seven

Handbook. Please include the business’s employee handbook so that all agency staff have access to it.

Tip: It is helpful to go through the company’s employee handbook with the intern so they understand what the expectations are of employees at this particular business.

Part Eight

More sections may be needed to cover any miscellaneous information that is specific to the business and/or the intern.

Tip: An important addition would be to obtain a letter of recommendation from the employer to include in the job seeker’s employment portfolio.

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 6

creative employment opportunities

Revolutionizing workforce diversity

Internship Program

Business Partner Agreement

[Agency Name] is excited to partner with _________________________________ in providing our pre-screened candidates the opportunity to expand their skill sets while serving the needs of your business. As an Internship Program Business Partner, your business is promoting work place diversity and equity by providing a series of community work based training experiences for our job seekers.

In order to ensure that our partnership with you is successful, we will provide the following services:

1. [Agency Name] will conduct an Internship Site Assessment.

2. [Agency Name] staff will provide on the job and ongoing support for both your business and our candidate during the duration of an internship.

3. [Agency Name] will assist your business in developing a series of internship opportunities.

4. [Agency Name] will assist interns in following the interview and orientation guidelines as determined with_______________________________________________.

As an Internship Program Business Partner you agree to:

1. Provide [Agency Name] a business liaison, who will serve as our primary point of contact in coor-dinating the internships.

2. Provide opportunities for [Agency Name] staff to complete an Internship Site Assessment.

3. Interview prospective internship candidates.

4. Work with [Agency Name] staff on continued development of internship opportunities.

5. Complete an Internship Evaluation at the midpoint and completion of internship experiences. This feedback will allow [Agency Name] staff to continually assess our partnership in order to foster continued success for your business and future interns.

6. Assist intern with completing and submitting time sheet to [Agency Name] at end of each pay period.

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 7

creative employment opportunities

Revolutionizing workforce diversity

Miscellaneous Internship Program Agreements:

1. Internships will not exceed a total of 45 days or a total of 40 hours, unless agreed upon by all parties.

2. Wages will be paid by [Agency Name], who will also be responsible for liability insurance.

3. This agreement does not require that the intern be hired or imply in any way that the intern will obtain permanent employment through ___________________________________________.

4. An internship may be terminated by any participating parties at any point.

5. The intern works through [Agency Name], and is not an employee of __________________________________ [Business Name and/or Agency Name].

______________________________________________________________________________________

Company Representative Signature and Title Date

______________________________________________________________________________________

Company Representative Signature and Title Date

 

8

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10

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11

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12

101 W

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t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

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13

101 W

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14

101 W

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kee, W

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15

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

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sity

crea

tive

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t be

a p

roble

m f

or

those

wh

o n

eed

ph

ysic

al

ass

ista

nce

get

tin

g

aro

un

d t

he

com

mu

nit

y. O

ne

als

o h

as

to c

ross

th

e tr

ain

tra

cks

if p

ark

ing

in

th

e n

ort

h p

ark

ing

lot. 

  Ente

rin

g t

he

rest

au

ran

t, t

her

e a

re n

o s

teps

wit

h o

ne

med

ium

siz

ed e

ntr

y w

ay.

Th

ere

are

no p

ow

er d

oors

, h

ow

ever

th

ere

is

usu

all

y a

host

sta

nd

ing

by

the

doorw

ay

wh

o c

an

ass

ist

in o

pen

ing

th

e d

oor.

In

sid

e th

e re

sta

ura

nt

ther

e a

re 3

flo

ors

. O

ne

ente

rs o

nto

th

e se

con

d f

loor

wh

ere

the

ma

jori

ty o

f th

e re

sta

ura

nt

sea

tin

g i

s lo

cate

d. T

her

e a

re t

wo f

lig

hts

of

sta

irs

up

to t

he

3rd

flo

or

wh

ere

an

oth

er s

ecti

on

of

rest

au

ran

t se

ati

ng

is

loca

ted

. T

her

e is

not

an

ele

vato

r. Th

e re

stro

om

s a

re a

cces

sible

wit

h

reg

ard

to s

ize

bu

t th

ere

are

no a

uto

ma

tic

doors

.    Th

ere

is a

good

am

ou

nt

of

room

bet

wee

n t

able

s on

th

e fi

rst

floor

an

d d

oes

not

app

ear

to b

e a

pro

ble

m f

or

those

wit

h p

hys

ica

l d

isa

bil

itie

s. 

  At

this

tim

e, t

her

e is

no B

rail

le o

n t

he

fron

t d

oor,

ta

ble

s or

rest

room

s. H

ow

ever

th

ere

are

ma

ny

sta

ff w

ho a

re a

vail

able

for

ass

ista

nce

if

nee

ded

Nei

ghbo

rhoo

d ch

arac

teri

stic

s    Th

e vi

lla

ge

of

Wa

uw

ato

sa w

her

e R

esta

ura

nt

A i

s lo

cate

d i

s fu

ll o

f re

sta

ura

nts

an

d s

ma

ll s

hops

. S

um

mer

Pla

ce i

s ve

ry c

lea

n

an

d u

sua

lly

bu

stli

ng

wit

h p

eopl

e. Th

e n

eig

hborh

ood

is

a m

ix o

f old

an

d n

ew b

uil

din

gs. 

 

16

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties  

Sam

ple

Soc

ial C

lim

ate/

Wor

k

Com

pany

Mis

sion

 

“Flo

wer

Gro

up’

s m

issi

on i

s to

en

rich

th

e li

ves

of o

ur

gu

ests

an

d o

ur

empl

oyee

s. W

e d

o th

is t

hro

ug

h a

su

peri

or q

ua

lity

in

foo

d

an

d b

ever

ag

es,

leg

end

ary

cu

stom

er s

ervi

ce,

an

d b

y tr

eati

ng

ou

r em

ploy

ees

like

fa

mil

y. W

e be

liev

e th

at

our

empl

oyee

s a

re o

ur

mos

t im

port

an

t a

sset

s a

nd

ou

r su

cces

s d

epen

ds

upo

n c

rea

tin

g a

nd

ret

ain

ing

a s

taff

ca

pabl

e of

del

iver

ing

an

exc

epti

ona

l ex

-pe

rien

ce t

o ev

ery

cust

omer

, ev

ery

tim

e.” 

Val

ue o

f A

chie

vem

ent:

On

a sc

ale

of 1

to 1

0, h

ow a

chie

vem

ent-

orie

nted

is th

e w

ork

envi

ronm

ent?

(T

en b

eing

dai

ly g

oals

and

che

ck-i

ns; o

ne b

eing

at

titu

de a

nd te

amw

ork

is m

ore

impo

rtan

t tha

n nu

mbe

rs) 

  Res

tau

ran

t A

’s e

mpl

oye

es w

ork

as

a t

eam

. V

alu

e of

ach

ieve

men

t ca

n i

ncl

ud

e m

an

y th

ing

s: c

ust

om

er s

ati

sfa

ctio

n,

empl

oye

es

work

ing

tog

eth

er,

lim

ited

loss

of

prod

uct

. F

or

thes

e re

aso

ns

valu

e of

ach

ieve

men

t w

ill

be

ran

ked

as

a “

5” 

Fle

xibi

lity

: On

a sc

ale

of 1

to 1

0, h

ow f

lexi

ble

is th

e w

ork

envi

ronm

ent?

(T

en b

eing

“an

ythi

ng g

oes”

; one

bei

ng “

no

exce

ptio

ns”) 

  Sin

ce R

esta

ura

nt

A i

s a

res

tau

ran

t, t

her

e a

re p

roce

du

res

an

d p

oli

cies

, es

peci

all

y re

ga

rdin

g h

an

dli

ng

food

, th

at

nee

d t

o b

e fo

llow

ed t

o a

“T”.

How

ever

, th

e ch

efs

are

oft

en c

om

ing

up

wit

h t

hei

r ow

n r

ecip

es o

n a

wee

kly/

mon

thly

ba

sis.

Wit

h t

his

in

m

ind

, fl

exib

ilit

y w

ill

be

ran

ked

as

a “

2”. 

Indi

vidu

alis

m v

s. C

olle

ctiv

ism

: On

a sc

ale

of 1

to 1

0, h

ow m

uch

does

the

wor

kpla

ce v

alue

team

wor

k? (

Ten

bei

ng e

very

one

pitc

hing

in o

n ev

ery

task

wit

h no

ass

igne

d jo

b ti

tles

; one

bei

ng e

ach

pers

on s

tick

ing

to a

n ar

ea o

f ex

pert

ise

and

focu

sing

on

thei

r ow

n li

st o

f du

ties

)    Em

ploye

es s

hou

ld f

oll

ow

th

e d

irec

tion

of

the

ma

na

ger

on

du

ty. E

mpl

oye

es a

re h

igh

ly v

alu

ed a

nd

work

tog

eth

er t

o p

rovi

de

exce

ptio

na

l cu

stom

er s

ervi

ce. R

esta

ura

nt

A h

as

an

ope

n d

oor

poli

cy a

nd

en

cou

rag

es a

ll e

mpl

oye

es t

o c

om

mu

nic

ate

wit

h

thei

r m

an

ag

ers

wh

en a

n i

ssu

e a

rise

s. M

an

y em

ploye

es d

o a

va

riet

y of

task

s a

nd

ste

p in

to “

an

oth

er p

osi

tion

” w

hen

nee

ded

.

Wit

h t

his

in

min

d,

Ind

ivid

ua

lism

vs.

Coll

ecti

vism

wil

l be

ran

ked

as

a “

9”. 

Em

ploy

ee V

alue

: On

a sc

ale

of 1

to 1

0, h

ow m

uch

do y

ou v

alue

em

ploy

ees?

(T

en b

eing

ful

l ben

efit

s, c

ompe

titi

ve w

ages

, and

enc

oura

gem

ent a

nd

impl

emen

tati

on o

f in

put;

one

bei

ng m

inim

al o

r no

rec

ogni

tion

)    R

esta

ura

nt

A v

alu

es t

hei

r em

ploye

es. C

ust

om

er s

ervi

ce i

s ex

trem

ely

impo

rta

nt

to t

his

bu

sin

ess

an

d R

esta

ura

nt

A m

akes

eve

ry

effo

rt t

o e

nco

ura

ge

thei

r st

aff

to h

ave

fu

n a

nd

en

joy

thei

r jo

b. H

ou

rly

empl

oye

es d

o n

ot

rece

ive

hea

lth

ben

efit

s, t

hey

do r

e-ce

ive

a f

ree

mea

l ea

ch s

hif

t. Se

rver

s m

ake

a s

erve

rs w

ag

e ($3

an

hou

r pl

us

tips

), c

ooks

earn

a c

om

peti

tive

hou

rly

wa

ge

an

d

ma

na

ger

s a

nd

ch

efs

are

sa

lari

ed. E

mpl

oye

e va

lue

wil

l be

ran

ked

as

a “

7”. 

 

17

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties  

Sam

ple

Gen

eral

Sit

e In

form

atio

n

Fun

: On

a sc

ale

of 1

to 1

0, h

ow f

un is

the

wor

k en

viro

nmen

t? (

Ten

bei

ng la

id b

ack

and

enga

ging

; one

bei

ng te

nse

and

sile

nt)  

  Res

tau

ran

t A

’s e

mpl

oye

es h

ave

fu

n a

nd

get

alo

ng

, h

ow

ever

du

rin

g p

eak t

imes

th

e w

ork

ca

n b

e ve

ry f

ast

pa

ced

an

d a

t ti

mes

a

re v

ery

ten

se a

s ev

eryo

ne

is t

ryin

g t

o w

ork

as

quic

kly

an

d e

ffic

ien

tly

as

poss

ible

. F

un

wil

l be

ran

ked

as

a “

5”. 

Impl

emen

tati

on o

f po

lici

es: D

oes

the

com

pany

/dep

artm

ent p

ract

ice

wha

t the

y pr

each

?    R

esta

ura

nt

A u

ses

thei

r m

issi

on

an

d v

alu

es i

n t

he

form

ati

on

an

d i

mpl

emen

tati

on

of

thei

r po

lici

es. M

an

ag

ers

mee

t on

a

wee

kly

ba

sis

an

d i

nfo

rma

tion

is

dis

sem

ina

ted

app

ropr

iate

ly. T

he

dep

art

men

t d

oes

pra

ctic

e w

ha

t th

ey p

rea

ch. 

Sta

irs: 

Th

ere

are

tw

o f

lig

hts

of

sta

irs

at

Res

tau

ran

t A

. O

ne

flig

ht

lea

ds

dow

n t

o t

he

kit

chen

an

d t

he

oth

er l

ead

s u

p to

a s

econ

da

ry

sea

tin

g a

rea

Ele

vato

r/E

scal

ator

Th

ere

is n

o e

leva

tor

in t

his

bu

ild

ing

; h

ow

ever

th

ere

is a

du

mb w

ait

er (

sma

ll e

leva

tor

for

dir

ty d

ish

es)

tha

t g

oes

fro

m t

he

top

floor

dow

n t

o t

he

kit

chen

Num

ber

of f

loor

s in

bui

ldin

g: 

Th

ere

are

th

ree

floors

in

Res

tau

ran

t A

. T

he

bott

om

flo

or

hou

ses

a s

ma

ll o

ffic

e, f

ood

sto

rag

e a

rea

an

d t

he

kit

chen

. T

he

seco

nd

flo

or

(m

ain

flo

or)

hou

ses

the

ma

in r

esta

ura

nt

sea

tin

g a

nd

ba

r a

rea

. T

he

3rd

flo

or

hou

ses

an

oth

er s

eati

ng

are

a a

s

wel

l a

s a

sm

all

dri

nk b

ar

(so

da

, w

ate

r a

nd

coff

ee/t

ea). 

Num

ber

of o

ther

bus

ines

ses

in b

uild

ing: 

Res

tau

ran

t A

is

loca

ted

in

a b

uil

din

g t

ha

t a

ppea

rs t

o b

e co

nn

ecte

d t

o t

he

bu

sin

ess

nex

t d

oor;

ho

wev

er i

t is

th

e on

ly b

usi

nes

s in

th

e bu

ild

ing

 

18

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties  

Sam

ple

Sp

ecia

l Pro

ced

ure

s

Uni

form

/Dre

ss:  

Res

tau

ran

t A

req

uir

es t

ha

t a

ll e

mpl

oye

es w

ear

a s

hir

t w

ith

Res

tau

ran

t A

an

d/o

r th

e Fl

ow

er R

esta

ura

nt

Gro

up

log

o o

n i

t.

Swea

tsh

irts

are

ava

ila

ble

for

purc

ha

se. M

an

ag

ers

on

du

ty a

re r

equ

ired

to w

ear

more

pro

fess

ion

al

att

ire. 

Che

ck in

and

out

pro

cedu

res: 

  Res

tau

ran

t A

req

uir

es a

ll e

mpl

oye

es a

rriv

e bet

wee

n 1

0-1

5 m

inu

tes

earl

y to

ass

ure

th

at

a s

hif

t is

sta

rted

on

tim

e. A

n e

mpl

oye

e m

ay

clock

in

no m

ore

th

an

5 m

inu

tes

earl

y u

nle

ss t

old

oth

erw

ise.

R

esta

ura

nt

A u

ses

a t

imek

eepi

ng

sys

tem

ca

lled

Alo

ha

; ea

ch

empl

oye

e is

giv

en a

n I

D t

o u

se. E

mpl

oye

es a

re r

equ

ired

to c

hec

k o

ut

at

the

end

of

the

nig

ht

as

wel

l. Th

e m

an

ag

er o

n d

uty

w

ill

let

som

e em

ploye

es g

o e

arl

y d

epen

din

g o

n t

he

nu

mber

of

cust

om

ers

in t

he

rest

au

ran

t. 

Req

uire

d cl

asse

s/ce

rtif

icat

ions

: Fo

r H

ost

s, S

erve

rs a

nd

Ser

vers

Ass

ista

nts

: Th

ere

are

9 m

od

ule

s th

at

ever

y h

ired

em

ploye

e n

eed

s to

com

plet

e. Th

ere

is a

lso 1

po

siti

on

spe

cifi

c m

od

ule

. S

ched

ulin

g: 

Sch

edu

les

are

post

ed e

very

Th

urs

da

y by

5pm

. S

ched

ule

ch

an

ges

mu

st b

e a

ppro

ved

by

the

ma

na

ger

AN

D w

ork

ers

are

req

uir

ed

to f

ind

th

e re

pla

cem

ent

for

thei

r sh

ift.

R

equ

ests

for

tim

e off

mu

st b

e su

bm

itte

d 2

wee

ks

prio

r to

th

e d

ate

of

the

requ

este

d t

ime

off

. D

ocum

enta

tion

nee

ded: 

  Res

tau

ran

t A

req

uir

es t

hei

r em

ploye

es t

o p

rovi

de

the

prope

r pa

perw

ork

to e

nsu

re t

hei

r st

aff

are

leg

all

y a

llow

ed t

o w

ork

in

th

e U

nit

ed S

tate

s. 

Em

ploy

ee id

enti

fica

tion

:    R

esta

ura

nt

A e

mpl

oye

es a

re r

equ

ired

to w

ear

a s

hir

t w

ith

th

e Fl

ow

er R

esta

ura

nt

Gro

up

log

o. E

mpl

oye

es a

re a

lso g

iven

an

ID

#

to e

nte

r in

form

ati

on

in

to t

he

com

pute

r. 

Hea

lth

and

safe

ty f

acto

rs/r

equi

rem

ents

:    Em

ploye

es n

eed

to b

e co

mpe

ten

t in

food

sa

fety

as

wel

l a

s co

gn

iza

nt

of

ma

inta

inin

g c

lea

nli

nes

s. Th

ey a

lso n

eed

to b

e a

wa

re

of

the

ma

ny

dif

fere

nt

envi

ron

men

ts i

n t

he

rest

au

ran

t in

clu

din

g t

he

ou

tdoor

spa

ce,

kit

chen

an

d d

inin

g r

oom

 

19

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties  

Sam

ple

En

viro

nm

enta

l In

form

atio

n

Su

b-e

nvi

ron

men

t #1

: K

itch

en 

Phy

sica

l lay

out/

Acc

essi

bili

ty: 

Th

e kit

chen

are

a h

as

two d

oors

th

at

serv

ers

use

: on

e d

oor

is f

or

ente

rin

g t

he

kit

chen

an

d o

ne

door

is f

or

exit

ing

. T

his

is

to

ensu

re t

he

safe

ty o

f se

rver

s a

s th

ey a

re c

arr

yin

g h

ot,

hea

vy d

ish

es t

o t

he

floor.

Th

e ce

nte

r of

the

kit

chen

ha

s m

an

y sh

elve

s th

at

hold

cookin

g u

ten

sils

: po

ts a

nd

pa

ns

to s

ilve

rwa

re,

etc.

Th

e co

okin

g a

rea

is

close

d o

ff,

exce

pt f

or

a s

ma

ll c

ut

ou

t a

t ey

e le

vel

wh

ere

cooks/

chef

s h

an

d t

he

food

ou

t to

ser

vers

; on

ly c

hef

s/co

oks

are

all

ow

ed i

n t

he

cookin

g a

rea

. I

n a

ba

ck c

orn

er t

her

e a

re

two l

arg

e in

du

stri

al

size

d s

inks

to r

inse

pla

tes

prio

r to

pla

cin

g i

n t

he

ind

ust

ria

l d

ish

wa

sher

. F

reez

ers

an

d r

efri

ger

ato

rs t

ha

t

hold

food

are

loca

ted

ag

ain

st t

he

wa

ll a

s is

ad

dit

ion

al

shel

vin

g f

or

dis

hes

Noi

se le

vel a

nd ty

pe: 

The

kitc

hen

ca

n b

e ve

ry n

oisy

as

ther

e a

re o

ften

ma

ny

peop

le c

omin

g i

n a

nd

ou

t, s

taff

ta

lkin

g,

dis

hw

ash

er r

un

nin

g,

etc. 

Lig

htin

g: 

The

kitc

hen

is

lit

excl

usi

vely

wit

h a

rtif

icia

l li

gh

tin

g (

exce

pt s

ome

open

fla

me

by t

he

gri

ll!) 

Tem

pera

ture

The

tem

pera

ture

ca

n g

et v

ery

hot

in

th

e ki

tch

en,

espe

cia

lly

nea

r th

e st

ove

an

d g

rill

are

a. 

Sm

ells

Va

riet

y of

food

sm

ells

dep

end

ing

on

wh

at

is b

ein

g c

ooked

 

20

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties  

Typ

e of

flo

orin

g: 

Ru

bber

, n

on

-sli

p fl

oori

ng

Num

ber

of s

taff

mem

bers

wor

king

in s

ub-e

nvir

onm

ent 

Ther

e a

re a

va

riet

y of

sta

ff m

embe

rs i

n t

he

kitc

hen

. A

t th

e bu

sies

t ti

me

ther

e a

re t

hre

e-fo

ur

cook

s/d

ish

wa

sher

s, o

ne

ma

na

ger

, tw

o se

rvin

g a

ssis

tan

ts a

nd

nu

mer

ous

serv

ers

com

ing

in

an

d o

ut

to g

et f

ood

.  

Oth

er: 

Th

e kit

chen

are

a c

an

look v

ery

dif

fere

nt

dep

end

ing

on

th

e ti

me

of

da

y. 

Su

b-e

nvi

ron

men

t #2

: M

ain

Din

ing

Are

Phy

sica

l lay

out/

Acc

essi

bili

ty: 

Larg

e ope

n r

oom

wit

h a

ba

r in

th

e ce

nte

r a

nd

ba

thro

om

s in

a b

ack

corn

er. T

her

e a

re m

ult

iple

ta

ble

s, v

ary

ing

in

siz

e a

nd

sea

tin

g. T

his

are

a i

s ve

ry a

cces

sible

to t

hose

wit

h p

hys

ica

l d

isa

bil

itie

s w

ith

wid

e w

alk

wa

ys a

nd

ta

ble

hei

gh

ts t

ha

t w

ou

ld a

c-

com

mod

ate

a w

hee

lch

air

Noi

se le

vel a

nd ty

pe: 

The

noi

se l

evel

is

con

sist

entl

y lo

ud

; th

ere

is u

sua

lly

mu

sic

pla

yin

g a

nd

a v

ari

ety

of p

eopl

e ta

lkin

g,

babi

es c

ryin

g,

etc.

Obv

i-

ousl

y, d

uri

ng

pea

k ti

me

the

noi

se l

evel

is

very

hig

h a

nd

off

pea

k it

is

quie

ter. 

 

21

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties  

Lig

htin

g: 

The

lig

hti

ng

is

a c

ombi

na

tion

of

art

ific

ial

an

d n

atu

ral.

Tw

o w

all

s a

re c

ompr

ised

of

win

dow

s a

nd

th

ere

is s

ome

art

ific

ial

lig

hti

ng

ove

rhea

d. 

  Tem

pera

ture

The

tem

pera

ture

on

th

e se

con

d f

loor

is

very

com

fort

abl

e; i

t ca

n b

e sl

igh

tly

wa

rmer

or

cold

er i

f on

e is

sit

tin

g o

r w

orki

ng

clo

se

to t

he

entr

an

ce. 

Sm

ells

Ther

e ca

n b

e a

va

riet

y of

foo

d a

nd

dri

nk

(cof

fee)

sm

ells

on

th

is f

loor

, a

s w

ell

as

a v

ari

ety

of p

erfu

mes

dep

end

ing

on

th

e

am

oun

t of

cu

stom

ers. 

Typ

e of

flo

orin

g: 

The

seco

nd

flo

or h

as

woo

d f

loor

s w

ith

are

a r

ug

s in

th

e fr

ont

entr

y w

ay. 

Num

ber

of s

taff

mem

bers

wor

king

in s

ub-e

nvir

onm

ent 

Ther

e a

re a

va

riet

y of

sta

ff m

embe

rs w

orki

ng

in

th

e d

inin

g a

rea

in

clu

din

g u

p to

nin

e se

rver

s, t

wo

bart

end

ers

an

d o

ne-

two

ma

na

ger

s. 

Oth

er: 

Th

ere

is a

sec

on

d s

eati

ng

are

a o

n t

he

thir

d f

loor

tha

t m

irro

rs t

he

layo

ut,

exce

pt f

or

the

cen

ter

ba

r. Th

e on

ly w

ay

up

to t

he

thir

d f

loor

is b

y u

sin

g t

he

sta

irs. 

 

22

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties  

Sam

ple

Sta

ff D

escr

ipti

on

Sta

ff s

ize: 

Th

e n

um

ber

of

sta

ff o

n d

uty

is

ba

sed

on

how

ma

ny

cust

om

ers

ther

e a

re i

n t

he

rest

au

ran

t. W

hen

th

e re

sta

ura

nt

is b

usi

er

(m

ost

ly F

rid

ay

lun

ch-S

un

da

y d

inn

er)

ther

e a

re a

bou

t n

ine

serv

ers,

tw

o s

ervi

ng

ass

ista

nts

, tw

o b

art

end

ers

an

d f

ou

r-fi

ve

cooks

an

d d

ish

wa

sher

s. Th

ere

wil

l a

lso b

e tw

o o

r m

ore

ma

na

ger

s on

at

an

y ti

me

as

wel

l. 

Num

ber

and

role

of

supe

rvis

or (

s): 

Th

ere

is a

lwa

ys o

ne

ma

na

ger

on

at

a t

ime

an

d d

uri

ng

pea

k h

ou

rs (

Frid

ay-

Sun

da

y) t

her

e a

re t

wo m

an

ag

ers

on

du

ty. D

ur-

ing

th

e pe

ak h

ou

rs a

ma

na

ger

(s)

wil

l be

on

th

e re

sta

ura

nt

floor

as

wel

l a

s in

th

e ki

tch

en a

rea

ma

kin

g s

ure

th

e ord

ers

are

g

oin

g t

o t

he

corr

ect

table

. T

he

ma

na

ger

s a

re r

espo

nsi

ble

for

post

ing

sch

edu

les,

app

rovi

ng

tim

e off

, tr

ain

ing

sta

ff a

nd

en

sur-

ing

th

at

rest

au

ran

t ru

ns

smooth

ly. 

 

23

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties

Sam

ple

Job

An

alys

is

 

Dut

ies/

Act

ivit

ies 

Cur

rent

ly P

erfo

rmed

by 

Pro

duct

ivit

y R

equi

rem

ents 

Qua

lity

Req

uire

men

ts 

Serv

e fo

od

to c

ust

om

ers.

Th

e

serv

ing

ass

ista

nt

wil

l fo

llow

(if

la

rge

ord

er)

serv

er t

o

corr

ect

table

wit

h f

ood

. O

r

they

mig

ht

be

resp

on

sible

for

rea

din

g t

he

tick

et

(w

hic

h l

ets

them

kn

ow

wh

ere

an

d t

o w

hom

th

e

food

is

to g

o)

an

d b

rin

g t

he

food

in

dep

end

entl

y. 

Serv

ing

Ass

ista

nt

an

d S

erve

rs 

Idea

lly,

th

e Se

rvin

g A

ssis

tan

t

wil

l ca

rry

4 p

late

s; h

ow

ever

the

most

im

port

an

t th

ing

is

to

get

th

e fo

od

to t

he

cust

om

er

wit

hou

t d

ropp

ing

it.

If

nee

d-

ed t

he

serv

ing

ass

ista

nt

can

carr

y le

ss t

ha

n 4

pla

tes 

Not

dro

ppin

g t

he

food

/pla

tes 

Get

tin

g i

t fr

om

th

e kit

chen

to

the

table

wit

hou

t it

get

tin

g

cold

 

Fill

sa

uce

cu

ps 

Serv

ing

Ass

ista

nt

an

d S

erve

rs 

To f

ill

sau

ce c

ups

wit

h t

he

cor-

rect

sa

uce

 

To f

ill

to t

he

corr

ect

lin

e so

tha

t th

ere

mig

ht

not

be

a l

ot

of

left

ove

r a

nd

/or

spil

lag

e. 

Roll

Sil

verw

are

 Se

rvin

g A

ssis

tan

t, S

erve

rs a

nd

Ma

na

ger

To r

oll

wh

en t

her

e is

no s

erv-

ing

or

clea

rin

g t

o b

e d

on

To r

oll

a f

ork

an

d k

nif

e in

a

bla

ck n

apk

in p

er R

esta

ura

nt

A’s

poli

cy 

Bu

ssin

Serv

ing

Ass

ista

nts

, Se

rver

s

an

d M

an

ag

ers 

To c

lea

n t

he

table

s a

s th

e cu

s-

tom

ers

lea

ve (

not

lea

ve t

he

table

dir

ty f

or

more

th

an

a

few

min

ute

s) 

To u

se t

he

rubber

bu

cket

to

pla

ce a

ll d

ish

es i

n a

nd

ca

rry

to s

ink a

rea

in

kit

chen

. I

f on

th

e 3

rd f

loor:

use

du

mb w

ait

er

to g

et t

he

bu

cket

dow

n t

o t

he

kit

chen

 

24

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties

Sam

ple

Job

An

alys

is (

con

tin

ued

)

 

Pre

requ

isit

e S

kill

s R

equi

red: 

Abil

ity

to s

pea

k c

lea

rly

an

d i

nte

ract

wit

h o

ther

s, i

ncl

ud

ing

str

an

ger

s. So

me

rea

din

g s

kil

ls n

eed

ed (

4th g

rad

e id

eall

y). 

Opp

ortu

niti

es to

exp

and

into

oth

er a

reas

/dut

ies

or le

arn

othe

r sk

ills

The

Serv

ing

Ass

ista

nts

wil

l m

ost

like

ly i

ncr

ease

th

eir

abi

lity

to

fol

low

ver

bal

inst

ruct

ion

as

tha

t is

th

e m

ain

wa

y th

ey r

ecei

ve

dir

ecti

on i

n t

his

pos

itio

n.

They

wil

l a

lso

incr

ease

th

eir

ha

nd

-eye

coo

rdin

ati

on a

s th

ey w

ill

be r

equ

ired

to

ma

nip

ula

te a

va

-ri

ety

of p

late

s a

nd

bow

ls.

The

Serv

ing

Ass

ista

nts

wil

l a

lso

ha

ve t

he

abi

lity

to

hon

e th

eir

cust

omer

ser

vice

ski

lls

as

they

wil

l co

me

into

con

tact

wit

h a

va

riet

y of

cu

stom

ers.

Res

tau

ran

t A

ha

s a

la

rge

nu

mbe

r of

ta

bles

an

d t

he

Serv

ing

Ass

ista

nt

wil

l co

me

to r

emem

ber

the

sea

tin

g c

ha

rt;

how

ever

, th

ere

is o

ne

post

ed o

n t

he

exit

doo

r of

th

e ki

tch

en f

or t

hem

to

gla

nce

at

prio

r to

bri

ng

ing

th

e fo

od o

ut.

La

stly

, th

e Se

rvin

g A

ssis

tan

ts w

ill

incr

ease

th

eir

wor

k st

am

ina

as

they

wil

l be

req

uir

ed t

o ca

rry

hea

vy p

late

s u

p a

nd

dow

n s

tair

s n

um

erou

s ti

mes

du

rin

g a

sh

ift. 

Res

tau

ran

t A

ha

s pr

omot

ed t

hei

r Se

rvin

g A

ssis

tan

ts t

o Se

rver

s a

nd

eve

n M

an

ag

ers

an

d C

ooks

/Ch

efs

wit

h f

urt

her

tra

inin

g. 

 

25

101 W

. Pleasan

t Street, Suite 108 • M

ilwau

kee, W

isconsin 53212  Phone (414) 277.8506 • Fax (414) 277.8547  ©

Crea

ve Employm

ent Opportunies, 

Rev

olut

ioni

zing

wor

kfor

ce d

iver

sity

crea

tive

empl

oym

ent o

ppor

tuni

ties

Sam

ple

Job

An

alys

is

(con

tin

ued

)

 

Pot

enti

al N

atur

al S

uppo

rts

(inc

iden

tal a

nd/o

r sy

stem

atic

): 

Du

rin

g t

he

pea

k h

ours

, th

e ki

tch

en w

ill

ha

ve a

ma

na

ger

on

du

ty (

Expo

). T

his

Exp

o d

irec

ts t

he

Serv

ing

Ass

ista

nts

or

the

ma

-jo

rity

of

thei

r sh

ift,

tel

lin

g t

hem

wh

ich

pla

tes

to b

rin

g w

her

e, w

ha

t n

eed

s re

fill

ing

or

clea

nin

g a

nd

wh

en t

hey

ca

n g

o on

br

eak.

Th

ere

are

a v

ari

ety

of S

erve

rs w

hom

th

e Se

rvin

g A

ssis

tan

t’s

wil

l h

elp

wh

en b

rin

gin

g l

arg

e or

der

s t

o ta

bles

. In

th

is

case

, th

e Se

rvin

g A

ssis

tan

t ca

n f

ollo

w t

he

serv

er t

o th

e ta

ble

an

d t

he

Serv

er w

ill

dir

ect

them

.  

Ove

rall

Com

men

ts/S

ugge

stio

ns/I

deas

Serv

ing

Ass

ista

nts

: A

gre

at

dea

l of

info

rma

tion

wa

s g

ath

ered

on

th

is p

osi

tion

an

d [

Ag

ency

Na

me]

fee

ls k

now

led

gea

ble

enou

gh

in

pro

vid

ing

a q

ua

lifi

ed e

mpl

oye

e (s)

for

this

posi

tion

. R

esta

ura

nt

A c

an

noti

fy [

Ag

ency

Na

me]

of

thei

r n

eed

s. 

Bu

ssin

g i

nte

rns:

Per

dis

cuss

ion

wit

h M

an

ag

ers,

Ser

vers

ha

ve o

pted

to d

o t

hei

r ow

n b

usi

ng

of

table

s so

th

at

they

ca

n k

eep

thei

r ti

ps. [

Ag

ency

Na

me]

ca

n p

rovi

de

bu

ssin

g i

nte

rns

an

d p

ay

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CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 26

creative employment opportunities

Revolutionizing workforce diversity

Part Three

Intern Criteria and Job Description. This section will include the specific qualities that the business is looking for in their interns and/or employees. The job description could be the standard description of the position used by the business OR it could be a customized job description that [Agency Name] developed with the business for the internship position.

Example Part Three

Desired Intern Characteristics:

1. Strong verbal skills

2. Able to stand for long periods of time

3. Comfortable interacting with multiple people at one time

4. Able to lift 25 pounds

5. Ability to have flexible schedule

Internship Job Description:

Include the business job description OR formulate the internship job description based on what was discussed with the business. It may be required that [Agency Name] will need to add information to the job description in regard to specific days the intern needs to work, background, etc. Be sure to include:

1. The job summary (including any specific days/hours the intern will have to work)

2. Work Environment

3. Essential Duties and Responsibilities

4. Knowledge, Skills and Abilities

5. Physical Requirements

 

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creative employment opportunities

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Part Four

The internship program strives to prepare people for a permanent position, therefore the application and inter-view process (if possible) should be the same or similar to the businesses’ current process.

Here is an example of the process:

Application and Interview Process

1. The candidate will complete an application and return it to the business with a [Agency Name] staff business card attached. This will alert the business’s staff that this application is for an intern position.

2. [Agency Name] staff will follow up via email to give the business a heads up about the application.

3. The business will follow up with [Agency Name] for a detailed discussion of the prospective intern.

4. A phone interview may be conducted.

5. A face to face interview with the intern, [Agency Name] staff and business will be conducted. This would be followed with a discussion of the specific work schedule and completion of any necessary paperwork if the business is willing to move forward with intern.

Sample Application:

Information

Name ___________________________________________ Birth date_____________________

Address_______________________________________________________________________

City __________________________ State__________________ Zip Code__________________

Telephone__________________________ E-Mail _____________________________________

 

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creative employment opportunities

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Work History

Employer  Dates Worked  Du es  Reason for Leaving 

 

     

 

 

     

 

 

     

 

     

 

     

 

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creative employment opportunities

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Education

References (non-family)

Name of School  Major/Course of Study  Grade completed, degree, cer ficate 

        

        

        

Name

  

Years Known  Rela onship  Contact Informa on 

 

  

        

 

 

  

        

 

 

  

        

 

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creative employment opportunities

Revolutionizing workforce diversity  

 

 

 

 

What are your career goals?

Why are you interested in interning at [name business]

Additional Comments:

For office use only 

Date Sent:_____________________ Date Received__________________

Notes:

 

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creative employment opportunities

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Part Five

Orientation and Training. Depending on the business agreement, think about the following questions: 1) Will the intern go through the orientation that hired employees go through or will there be an individualized orien-tation for the intern? (This determination might depend on the assets and barriers of the specific intern). 2) Will there be an agreed upon amount of time for training that is or is not included in the length of the intern-ship? 3) Who will do the training? Ideally, the business should conduct as much of the orientation and train-ing as possible with the agency staff on the side providing support as needed

Example Part 5

Orientation/Training Example:

1. For this business, the intern will go through the same orientation as any other employee. This orientation takes place every third Thursday from 4-7pm. It is important that a job coach accompany the intern. It is recommended that interns start the Monday following their orientation.

2. The orientation is given by John Doe.

3. Interns will be considered “in training” for the first 6 hours on the job. It is preferable to split this up into two-three hour shifts during non peak times: e.g. 9am-noon during a Monday-Friday.

4. Training will be provided by the manager on duty. It is important for the job coach to be present 100% of the time during the training period.

 

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Creative Employment Opportunities, Internship Performance Evaluation

 

 

Intern’s Name: ______________________________ Worksite:_____________________________

Date: ______________________________________ 20 hr. review 40 hr. review

Performance Rating: Always Most of the time Some of the time Never

1. Dependability

a. Attendance is consistent 4 3 2 1 N/A

b. Arrives to work on time 4 3 2 1 N/A

c. Returns from lunch or break on time 4 3 2 1 N/A

d. Notifies supervisor of illness/absence 4 3 2 1 N/A

2. Personal Appearance

a. General appearance is neat and clean 4 3 2 1 N/A

b. Seems to care about appearance 4 3 2 1 N/A

c. Dress is acceptable for type of work 4 3 2 1 N/A

3. Relationship with Supervisor

a. Listens to Instructions 4 3 2 1 N/A

b. Follows through on instructions/training 4 3 2 1 N/A

c. Accepts constructive criticism 4 3 2 1 N/A

d. Works adequately with reasonable 4 3 2 1 N/A

amount of supervision in comparison to

other employees

4 3 2 1 N/A

 

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creative employment opportunities

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4. Quality of Work

a. Is able to perform all tasks in job description 4 3 2 1 N/A

b. Asks questions when s/he does not

understand 4 3 2 1 N/A

5. Quantity of Work

a. After adequate training, works at speed 4 3 2 1 N/A

comparable to other employees

b. Is able to work at an acceptable pace 4 3 2 1 N/A

throughout work shift.

6. Initiative

a. Keeps busy between assignments or when 4 3 2 1 N/A

not directly supervised

b. Asks for additional work when completed 4 3 2 1 N/A

with assigned tasks

7. Customer Service

a. Friendly and courteous to customers 4 3 2 1 N/A

b. Friendly and courteous to co-workers 4 3 2 1 N/A

8. Overall, how would you rate this Excellent Good Fair Needs

Intern’s performance? Improvement

 

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9. Based on this rating, what areas of the intern’s performance could be improved upon?

10. Based on this rating, what are the strengths of this intern?

11. Additional Comments:

Supervisor Signature Date

Intern Signature Date

 

CEO Staff Signature Date

Outcome:

Continue Internship: YES NO N/A (End of Internship)

Letter of Recommendation: YES NO

Other: ___________________________________________________________________________________________

 

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Agency Internship Evaluation Cover Sheet

Intern Name: Address: Phone: ( ) SS#: Date of Birth: Parent/Guardian: Phone/Email: Counselor: Phone/Email: Host Company: Department(s): Supervisor(s): Start Date: End Date: Internship Days/Hours:

Job Duties (list/describe): Employment History (past internships, employment, volunteer experiences): Interests/Preferences:

Sunday  Monday  Tuesday  Wednesday  Thursday  Friday  Saturday 

             

 

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creative employment opportunities

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Current Financial Status (describe benefits which may be affected by employment; e.g., SSI, SSDI): Transportation: Health Status (medication, sensory, communication, personal care needs):

 

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Internship Overview Evaluate & comment on each work competency listed.

Combine with supervisor’s evaluation to develop recommendations. Recommendations

(extend work experience, additional work experiences, type of employment, work culture, environment, etc.)

___________________________________________________ _______________ Intern Signature Date ___________________________________________________ _______________ Evaluator Signature Date

Attendance/Punctuality:   

4  3  2  1 

Hygiene:   

4  3  2  1 

Response to supervision (from supervisor, co-workers, evaluator):   

4  3  2  1 

Ability to follow directions (verbal, written, demonstration, from whom):   

4  3  2  1 

Tolerance for re-instruction/constructive feedback:   

4  3  2  1 

Endurance/Stamina:   

4  3  2  1 

Ability to meet productivity requirements:   

4  3  2  1 

Ability to meet quality requirements:   

4  3  2  1 

Independent/Interdependent work ability (completing tasks, asking for assistance):   

4  3  2  1 

Communication (with supervisor, co-workers, customers):   

4  3  2  1 

Initiative:   

4  3  2  1 

Motivation to work:   

4  3  2  1 

Learning Style (Logical/Mathematical; Visual/Spatial; Bodily/Kinesthetic; Musical; Interpersonal; Intrapersonal):     Adaptations/Special equipment needed:     Strengths displayed during internship:     Areas of need displayed during internship:     

 

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©Crea ve Employment Opportuni es, Inc. 2012 38

creative employment opportunities

Revolutionizing workforce diversity Sample Agency Internship Evaluation

Cover Sheet

Intern Name: Bryce Johnson Address: 123 Spring Street Summerville, WI 55555 Phone: (414) 555-1212 SS#: 333-11-5555 Date of Birth: August 15, 1998 Parent/Guardian: Sheila & Chad Johnson Phone/Email: same /[email protected] Counselor: George Smith Phone/Email: 414-555-4321 [email protected] Host Company: Walgreens Department(s): General stocking & photo Supervisor(s): Mark Chovaz (Patti London – co-worker) Start Date: 03/01/12 End Date: 04/15/12 Internship Days/Hours:  Job Duties (list/describe): Face items on shelves; stock new items that arrive (putting new

items forward), assisting in photo lab (processing photos), customer service Employment History (past internships, employment, volunteer experiences): Penzey Spices – warehouse – 11/1/11 to 12/15/11 Joy Cleaners – sorting laundry & recycling hangers – 1/15/12 – 2/15/12 Volunteers at the local food pantry every Saturday (has done this for 3 years) Interests/Preferences: Enjoys being around people, but working on his own Prefers activities that require movement (e.g., both standing and sitting) Hobbies include riding his bike, Special Olympics (bowling & track), and listening to music (country)

Sunday  Monday  Tuesday  Wednesday  Thursday  Friday  Saturday 

  1-4pm  1-4pm  1-4 pm  1-4 pm  1-4 pm  1-4 pm 

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 39

creative employment opportunities

Revolutionizing workforce diversity  

 

 

 

 

Current Financial Status (describe benefits which may be affected by employment; e.g., SSI, SSDI): Bryce currently receives SSI – a Benefits Analysis will be completed to identify the im-pact his earnings will have on his benefits and possible work incentives that can be used to support him on a job longer term. Transportation: Bryce currently rides his bike to most activities. He did take the bus to Penzey Spices but is not able to transfer (so a direct bus route would be okay). Health Status (medication, sensory, communication, personal care needs): Bryce wears glasses, but doesn’t like to wear them and needs to be reminded. He also needs to be reminded to clean his glasses from time to time. Bryce communicates ver-bally in 2-3 word phrases/sentences. When he is under stress, it can be difficult to un-derstand Bryce. If asked to “say it differently”, Bryce will rephrase his question or comment. Bryce takes Ritalin to help him focus.

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 40

creative employment opportunities

Revolutionizing workforce diversity  

 

 

 

Sample Internship Overview Evaluate & comment on each work competency listed.

Combine with supervisor’s evaluation to develop recommendations.

Ratings: 4=Excellent 3=Good 2=Fair 1=Needs Improvement

Attendance/Punctuality: Bryce was always 10 minutes early to work and had no ab-sences during the internship. 

4  3  2  1 

Hygiene: Other than reminding Bryce to clean his glasses before his shift, his hygiene was appropriate for the work environment 

4  3  2  1 

Response to supervision (from supervisor, co-workers, evaluator): Bryce listened well to his co-workers when they gave him new tasks to complete. He had difficulty asking for new tasks when he finished and did not take the initiative to “find” tasks to do. 

4  3  2  1 

Ability to follow directions (verbal, written, demonstration, from whom): Bryce followed direc-tions best when the task was demonstrated by his supervisor or co-worker and paired with verbal instructions. 

4  3  2  1 

Tolerance for re-instruction/constructive feedback: Bryce tolerated feedback well if it was brief – too much talking distracted him. If he needed re-instruction on com-pleting a task, it was best to show him and use limited words . 

4  3  2  1 

Endurance/Stamina: Bryce has great endurance and stamina – he worked his 3 hour shift every day and did not seem tired or warn out after work. 

4  3  2  1 

Ability to meet productivity requirements: Bryce often would exceed the productivity re-quirements – often finishing his stocking an hour before his shift ended. This is where initiative in finding new tasks to do or asking his supervisor/co-workers for more duties would have helped his performance. 

4  3  2  1 

Ability to meet quality requirements: Bryce did what he was told and did the job well. However he did not find tasks to do on his own with regard to keeping the store clean or facing the items on the shelves. 

4  3  2  1 

Independent/Interdependent work ability (completing tasks, asking for assistance): Bryce was very independent – sometimes too independent. He did not ask for assistance when he needed it (e.g., finding an item on the shelf for stocking – he would keep walking around the store – and often walk past the item several times). 

4  3  2  1 

Communication (with supervisor, co-workers, customers): Bryce communicated with his co-workers and supervisors only when they spoke to him. Bryce did not initiate conversation or ask questions when he did not understand an assignment. He was friendly to customers, but would not initiate (e.g. asking if they needed help or saying hello) and would wait for customers to approach him. 

4  3  2  1 

 

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©Crea ve Employment Opportuni es, Inc. 2012 41

creative employment opportunities

Revolutionizing workforce diversity  

 

 

 

 

Recommendations (extend work experience, additional work experiences, type of employment, work culture, environment, etc.)

Of the 3 work experiences Bryce completed, he liked Walgreens the best. He enjoyed the work environment (his co-workers and the customers) and tasks (sitting to price items, standing and walking, working with customers). An employment portfolio that includes the employer evaluations and letters of recommendation along with photos of Bryce doing the various jobs will be put together. Bryce can then go out with his Employment Consultant to talk with businesses about his work and what he would like to do. Working in an environment with a variety of tasks and interactions would be the best for Bryce. Bryce Johnson 4/20/12

Intern Signature Date Belinda Simmons 4/20/12 Evaluator Signature Date

Initiative: This is an area for Bryce to improve on. Once completed with a task, he would wander around the store and did not take the initiative to find other tasks to do (e.g., he could always face items on the shelves but would wait to be told to do so).   

4  3  2  1 

Motivation to work: Bryce is very motivated to work – he stated that he enjoyed this internship because he liked being around people. He also enjoyed get-ting his paycheck every 2 weeks! 

4  3  2  1 

Learning Style (Logical/Mathematical; Visual/Spatial; Bodily/Kinesthetic; Musical; Interpersonal; Intrapersonal): Bodily-Kinesthetic and Intrapersonal – Bryce likes to process information provided to him for 2-3 minutes before trying it out on his own.   Adaptations/Special equipment needed: An iPod touch might be helpful to remind Bryce of other tasks he could be working on when he finishes an assignment from his supervisor. He could be taught that once he finishes a job, he should look at his iPod touch for other duties to work on. Strengths displayed during internship: Once Bryce learns the job, he is very efficient. He followed direc-tions well and has great stamina on the job. Bryce was very productive on the job meeting or exceeding the productivity expectations. Areas of need displayed during internship: Taking initiative and asking for assistance are the biggest areas to work on. Another area to work on would be initiating communication with super-visor, co-workers and customers. 

 

CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 42

creative employment opportunities

Revolutionizing workforce diversity

Notes 

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CEO is a program of TransCen, Inc. www.transcen.org/www.ceomke.com 

©Crea ve Employment Opportuni es, Inc. 2012 43

creative employment opportunities

Revolutionizing workforce diversity

Notes 

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CEO is a program of TransCen, Inc.  www.transcen.org/www.ceomke.com  

©Crea ve Employment Opportuni es, Inc. 2012  

Developed by: Laura Owens, Ph.D., CESP Andrzej Walz-Chojnacki

David Richards