Exhibit_G_-_Affirmation_of_Qualifications_-_Pre-ETS.docx
DOCX document 19 KB Posted
- Attached to
- Master Agreement AZ|CTR056121
- Contract number
- CTR056121
- Issued by
- Arizona
About this file
This document is an Affirmation of Qualifications form for Pre-Employment Transition Services (Pre-ETS), specifically related to service providers working with Rehabilitation Services Administration (RSA) clients. The form outlines detailed qualification requirements for personnel who will be delivering direct services to individuals with disabilities, focusing on verifying professional credentials, educational backgrounds, and experience levels of service providers.
The qualification criteria are comprehensive, allowing service providers to meet requirements through various combinations of education and work experience, such as having a Master's degree with one year of disability-related employment, a Bachelor's degree with three years of experience, a high school diploma with seven years of experience working with individuals with disabilities, or alternative qualifications with appropriate supervision. Additionally, the document includes specific requirements for sign language interpreters, mandating valid licensing or certifications from recognized professional organizations, and provisions for foreign language service providers who can communicate effectively in their designated language.
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Affirmation of Qualifications Pre-Employment Transition Services Legal Business Name:
| I affirm that | , an |_| employee OR |_| subcontractor, shall be providing direct services to RSA clients as specified in the contract and meets the following qualifications: | ||
| |_| | Has documented knowledge and competence in disabilities awareness, in barriers and issues preventing individuals with disabilities from entering and succeeding in the workplace, in strategies necessary for achieving successful, long-term employment outcomes for individuals with disabilities and how these strategies lead to improved employment outcomes, and in work readiness and employment skills AND | ||
| |_| | Has a Master’s Degree in a related field (e.g., Rehabilitation Counseling, Psychology, Sociology, Education, etc.) and documentation of one (1) year of full-time employment working with individuals with disabilities; OR | ||
| |_| | Has a Bachelor’s degree in a related field (e.g. Rehabilitation Counseling, Psychology, Sociology, Education, etc.) and documentation of three (3) years' full-time employment in working with individuals with disabilities; OR | ||
| |_| | Has a high school diploma or G.E.D. and documentation of seven (7) years of experience directly working with individuals with disabilities, preferably involved in the provision of vocational rehabilitation services; OR | ||
| |_| | Does not have the above qualifications, but is providing direct services under this contract and has a high school diploma or G.E.D. and one (1) year of documented experience (preferably working with individuals with disabilities and involved in the provision of vocational rehabilitation services). This individual shall be utilized only as follows: | ||
| On a limited basis and when assigned tasks that would be considered preliminary or less technical in nature, and | |||
| Under the direction and supervision of staff member who meets the criteria above. | |||
| |_| | Will be providing direct services to clients under this contract utilizing American Sign Language and | ||
| |_| | has a valid Arizona Sign Language Interpreter license OR | ||
| has one of the following certifications: | |||
| |_| | Registry of Interpreters for the Deaf (RID) Certificate of Interpretation as listed in the Scope of Work | ||
| |_| | Board for Evaluation of Interpreters Basic, Advanced, Master, Court Interpreter | ||
| |_| | National Association of the Deaf Interpreting Certification (NAD) IV or V; | ||
| |_| | Sign Communication Proficiency Interview (SCPI) rating of Intermediate or above | ||
| |_| | American Sign Language Teacher’s Certification (ASLTA) Qualified or Professional levels | ||
| |_| | Will be providing direct services to clients under this contract utilizing a foreign language and is able to communicate effectively and accurately using the foreign language. By signing this affirmation we assume responsibility for their performance. |
In signing below, I affirm that this person has the qualifications noted above and the documentation is on file with this business.
| Printed Name | Title | Date |
2018-09-27 bw
File details come from the government source that posted it. Updated .