ME NMW Parent Interview Form.doc

DOC document 151 KB Posted

Attached to
New Mexico Temporary Assistance to Needy Families (TANF) / NM Works Program Providers
Solicitation number
11-630-9000-0010
Issued by

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Form used in ME for Participant/Parent Interviews

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Text version

NMW PARENT INTERVIEW

INCOME SUPPORT DIVISION

Parent’s Name

Social Security Number

Current Work Activity

CDS
ISD Eligibility Worker

Date

Interviewer

TeamWorks
Yes
No
Not Applicable
Don’t know
Comments

WORK AND SUPPORTIVE SERVICES

1. Has the NMW program assisted you with the following activities?

a. Finding a job

b. Creating a resume

c. Completing an application

d. Basic Education – Life Skills, GED, ESL

e. Vocational Education and Training

f. College Education

2. Has the NM Works program assisted you with:

a. Being excused from work participation b.. Housing c.. Transportation (including mileage reimbursement, gas card, bus passes) d.. Child care e.. Domestic Violence, Substance Abuse Services and/or Mental Health Services f.. Money management and paying off debts

3. Is your Career Development Specialist responsive and available to you?

4. Was your orientation scheduled at a convenient time?

5. Did your Career Development Specialist talk to you about how to achieve your long-term goals and become employed?

6. Is the office easy to get to and are the office hours convenient?

7. Did the NMW office fully explain the following:

a. Difference between core (primary) and non-core (secondary) activities?

b. The number of core/non-core hours needed each week?

c. The significance of reporting your work activity hours?

d. How to complete a timesheet or other required forms?

e. The work related services to which you’re entitled such as the $300 reimbursement?

f. Other Human Services Department programs, such as transition bonus and LIHEAP?

g. How to file a complaint if you felt dissatisfied with the service you received?

h. How to contact your CDS?

8. In what ways has this site served your needs?

9. What has helped you the most?

10. In what ways has it not met your needs?

11. Have you been referred to other agencies for support services? If so, which ones? How well have these referrals worked for you?

12. Is there any other type of assistance/referral that you would like to request now?

13. Are there any other thoughts, questions, and concerns that you would like to bring to our attention?

PAGE

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