Today’s Date This Worksheet Is Getting Me Ready Before My .
Information About Me for Person-Centered PlanningName Today’s DateThis worksheet is getting me ready before my Person-CenteredPlanning Meeting on (date) I will make this plan with caring people that I trust. The plan will help me live the life that I want. The plan will last one year, unless I ask for changes sooner.1. This is what is most important to me:2. My favorite things and interests are:3. These are the people that are important to me and whythey are important:Getting My Own Address 2015 Linda Ronan Brown, Elizabeth Ann Kowalski
Information About Me for Person-Centered Planning4. These are my dreams and goals:5. These are my abilities. I can: Practice good hygiene Spend within my budget Dress by myself Make doctor appointments Take medicine by myself Refill my medication Cook or bake my meals Use my medical equipment Do my laundry Drive a car Vacuum and dust Use an alarm clock, timer Clean bathrooms Manage my time well Clean my room Use a schedule or calendar Mow the lawn Make plans by myself Shovel snow Solve problems Rake leaves Get help when needed Change light bulbs Stay safe in the community Buy groceries Other Pay the bills OtherGetting My Own Address 2015 Linda Ronan Brown, Elizabeth Ann Kowalski
Information About Me for Person-Centered Planning6. I need help with:Every dayweeklymonthly or lessEvery dayweeklymonthly or lessEvery dayweeklymonthly or lessEvery dayweeklymonthly or lessEvery dayweeklymonthly or lessEvery dayweeklymonthly or lessEvery dayweeklymonthly or less7. To be in the community, I need these supports. (Youmay write about people, money or funding, equipmentand anything else you need):8. I can walk to these places. (You may write none, alone,or with support):Getting My Own Address 2015 Linda Ronan Brown, Elizabeth Ann Kowalski
Information About Me for Person-Centered Planning9. I need help setting up my transportation. YesNo10. I need someone to drive me in a car to these places:11. I can use a bus to these places. (You may write none,alone or with support):12. I need specialized transportation equipment. Yes No13. At home, I need these supports to stay safe, healthyand happy. (You may write about people, money orfunding, equipment and anything else you need):Getting My Own Address 2015 Linda Ronan Brown, Elizabeth Ann Kowalski
Information About Me for Person-Centered Planning14. These are my health concerns and medical needs:15. This is where I want to be living in two to five years:My dream place to live some day is:To live more independently, I need to make progress.These are the things we will work on next.My List:My Supports Coordinator’s List:Getting My Own Address 2015 Linda Ronan Brown, Elizabeth Ann Kowalski
Information About Me for Person-Centered PlanningMy Family’s List:16. Other things I want to talk about at the PCP meeting:My supports and services should be watched to besure things are going well. How will the supports andservices be watched? Who will watch them?Getting My Own Address 2015 Linda Ronan Brown, Elizabeth Ann Kowalski
Information About Me for Person-Centered PlanningAfter the Person-Centered Planning MeetingThis year’s plan date:These people will help me work on the steps in thisyear’s plan to reach my goals. (List the person and thegoal):Consider if this year’s plan is working well. Am Ihappy with my services and the choices that were made?Do I have enough money to do what is in my plan?I should tell someone about problems. I may ask forhelp. If I need to, I will ask my Supports Coordinator tochange my plan.Getting My Own Address 2015 Linda Ronan Brown, Elizabeth Ann Kowalski
Information About Me for Person-Centered PlanningAm I happy with my progress on my goals?Sometimes my interests, preferences and needs change.How are things different since the last Person-CenteredPlanning meeting?What are my ideas for next year’s plan? I should writethem down. Then I will have a list to talk about before mynext Person-Centered Planning meeting.Getting My Own Address 2015 Linda Ronan Brown, Elizabeth Ann Kowalski
This worksheet is getting me ready before my Person-Centered Planning Meeting on (date) _ I will make this plan with caring people that I trust. The plan will help me live the life that I want. The plan will last one year, unless I ask for chang
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Lesson 2: Personal hygiene, worksheet B Lesson 2: Food hygiene, worksheet C Lesson 3: Food storage, worksheet D Lesson Plan: Diet and health Lesson 4: Healthy eating, worksheet E Lesson 5: Balanced diet, worksheet F and G Lesson 6: Healthy choices, worksheet H Food hygiene and safety word search, worksheet I Pupil Assessment Pupil Certificate
