Human Services – Work Experience
Instructor: Donette Steele, M.A.
71 AD – 2 Unit/ 72 AD – 3 Unit/73 AD – 4 Unit
Text Book: Required -
Enrolling/Paperwork August 28
Turn in Paperwork as indicated in email:
Original WE Application – signed and dated
Copy of Class Schedule
Agency Agreement (Risk Services)
Supervisor’s Letter – signed and dated
Ten Things You Will Do at Your Job
Failure to submit these documents will result in student being dropped from class.
Work on Application Form (formerly referred to as the Green Form)
Work on Objective Form (formerly referred to as the Pink Form)
NO - WE Hours may be counted until Application Form and Objective Form are completed by student and signed by Supervisor.
NO – WE Hours may be counted before the second week of the class 9/4/2012
Students must have work hours for each week of the semester or no credit will be issued for class. (If you complete your
WE hours early you must still continue at your site placement – a minimum of one hour per week until the semester ends.)
Submission of all Application Form and Objective Form for Class - 9/11/2012
Must be complete, signed and dated by supervisor and student
Failure to submit by this date will result in student being dropped from class.
All paperwork complete with correct information, all objectives complete, all supervisor’s and student’s signatures
must be in place. Paperwork needs to be approved by the Instructor on this date. Failure to have completed paperwork on this
date with Instructor’s approval will result in student being dropped from the class.
Read the following chapters before class meets and be prepared to discuss topic from chapter and complete Exercises from
textbook as assigned weekly by Instructor.
At the end of the semester you will be required to submit copies of all work completed for the semester. A small three
ring binder is required.
The required paperwork will consist of and be placed in folder in the following order.
1. All Initial Paperwork completed by you: Copy of your Original Application for a Permission Number sent to me when
you applied to be in the course.
Copy of your class schedule
Copy of Supervisor’s Letter
Copy of Agency Agreement
2. All Paperwork – Official Application Form and Objective Form
3. All Graded Workbook Assignments (originals)
4. A printed copy of your Presentation (you will present in Power Point format)
5. Copy of Sober Living Survey (you will present original to Instructor on due date)
6. A copy of your Resume and Mock Interview assessment
7. Copies of all time cards (originals will be turned in to 7Instructor Separately)
All Paperwork must be kept in Folder
Workbook assignments will be not be completed by last semester’s WE Students.
Students from last semester will be given a minimum of two students to Mentor during the semester. You will also keep a
1. All Initial Paperwork for class
2. Written reports on working with your Mentees – a minimum of one entry per Mentee per week.
You will detail all information discussed with your Mentee on a week to week basis, outside of class .
3. Mentee Grade and Attendance Roster: You will be required to give a rating on each Work book.
Ratings will be as follows: Excellent = 4, Good = 3, Fair = 2, Poor = 1, Not completed = 0. Write rating, your initials
and date received. in the top right hand area of Worksheet. Submit to Mentor Supervisor for Grade Assignment Exercise completed
by your mentees. You will receive a completed Worksheet each week from your assigned Mentees and return the following week
rated to the Mentor Supervisor for assessment and letter grade. No late submissions accepted.
Grading criteria will be discussed with you by your Mentor Supervisor.
9/04 - Bring in Application Form (aka Green Sheet) and Objectives Form (aka Pink Sheet)
9/11 - Chapter 1 Exercises – 1.1, 1.2 Turn in completed and approved Application Form and
Objectives Form with all signatures (must be signed and dated by supervisor prior to 09/04)
9/18 - Chapter 2 Exercises – 2.2, 2.4
9/25 - Chapter 3 Exercises - 3.2, 3.3, 3.4
10/02 - Chapter 4 Exercises – 4.1, 4.2, 4.3
Download and print Sober Living House Survey complete and turn in on 10/30
10/09 - Chapter 4/5 Exercise - 4.5 and 5.1, 5.2 (only questions #3 and #4 in 5.2)
Mock Interviews with completed Resume
10/16 - Chapter 5/6 Exercises – 5.4, 6.1
Mock Interviews with completed Resume
10/23 - Chapter 6 (cont.) 6.2, 6.3
10/30 - Chapter 6 Exercises 6.5, 6.6
Completed Sober Living House Survey Due
11/ 06 - Chapter 7 – 7.1, 7.2
11/ 13 - Chapter 7 – 7.3, 7.4
11/20 - Chapter 8 - 8.1
11/27 - Chapter 9 – 9.1
12/03 - Chapter 9 - 9.2 Time Card Review
12/10 Submit all Paperwork (Original timecards etc.)
Final Date to be Announced – Turn in Student Folder / Portfolio with all completed assignments.
Students will complete and present a PowerPoint Presentation on their Work Site Placement.
Topics to be discussed.
Student Learning Outcomes:
1. Formulate three work-related objectives; the content
and nature of those objectives will vary by student, and demonstrate these objectives during the work experience process.
2. Evaluate job specific skills and responsibilities so as to enhance employment options.
3. Critique a simulated
job interview through a role-play scenario.
4. Create Power Point Presentation on Work Site
Semester Grade will be based on
the following criteria:
Initial Paperwork completed correctly
– 300 points
Completion of Exercises in Textbook
weekly as indicated. Late submissions will be given no credit. 10 points per
exercise = 260
Sober Living Questionnaire/ Survey
= 120 (not completed = -200 points)
Timecards completed correctly, sufficient
number of hours and correct signatures with copy for Instructor turned in monthly – 50 points per month / 200 points
Time card review – attended
and completed. – 100 points
Completed Original Time Cards turned
in on 12/10 – 200 points
Evaluation by Employer – 300
points possible depending on rating.
Attendance – 10 points per
class = 100 points (missing more than three classes you will automatically be dropped by Instructor) Attendance bonus –
50 points for no absences.
Mentee Portfolio – Complete
= 500 points
Missing any information or assignment = 0 points
Presentation of Power Point - 200
Mock Interview and Resume = 250
Absent for any Student Presentation
= -100 points for each class
90 to 100% of points = A
80 to 89% of points = B
to 79 % of points = C
60 to 69% of points = D
Below 60% of points = F
OFFICE HOURS: I will be available in the classroom after
class. I am also available by appointment.
I can also be reached at (562) 8568122. Leave a return number and the
best times to reach you. I will not return calls if you have any type of call
blocking on your line as I will not release my home number. My email address
is email@example.com I will return email promptly.
EMAIL: Email will not be opened by the Instructor unless the subject line includes your name,
name of the college and course name. Email me at firstname.lastname@example.org. Do not email at the Cerritos.edu email address as I do not frequently check this. Do not call the college with messages for the instructor as the Department does not
accept messages. Do not call me with a message that you will not be in class,
this is your responsibility and not mine. Again, do not the email address at
the college. My email address is email@example.com
ASSIGNMENTS: Do not call me and ask what the assignments are OR what chapter we are on OR when your
presentation is or what group you are in. Get group information and work with
them. Do not ask me, if you miss class, if you missed anything important as it
is all IMPORTANT.
All original time cards must be brought to class on date indicated on syllabus
The same supervisor as indicated on Objective Sheet (aka PINK SHEET) is the only person allowed
to sign time cards. Complete names must be signed (no nick names or initials)
TIME CARD REVIEW
NAME: __________________ CLASS (indicated
71, 72 or 73 AD) _______Instructor_________
DO NOT USE FRACTIONS SUCH AS ½ ON YOUR TIME CARDS OR ON THIS SHEET USE DECEMICALS
½ = .5 ¾ = .75
WEEK ONE : NA
WEEK ONE ________
WEEK TWO: NA
WEEK THREE: _______
WEEK THREE _______
WEEK FOUR ________
TOTAL FOR AUG. __________
FOR SEPT. ________
NOV. DEC. WEEK
WEEK ONE _________ WEEK
WEEK TWO _______
WEEEK TWO ________ WEEK TWO______
WEEK FIVE ________
WEEK FIVE _________
TOTAL FOR OCT. ________ TOTAL FOR NOV.
WEEK ONE __________
TOTAL FOR DECEMBER _________
CLASS # HS_____ (71, 72, or 73) which equals ____________HOURS
TOTAL HOURS I NEED TO COMPLETE COURSE______Indicate
TOTAL HOURS I HAVE COMPLETED _____________
Work Experience Hours / Paperwork Student Responsibility
_____________________, Student #_________________ have completed the following Number of hour’s _________ for Work Experience. To receive credit for this course I need to complete ________ hours. I
am a PAID/ VOLUNTEER WORKER (circle one). I certify that I have completed the minimum number of hours necessary to received Credit in
this course. I understand that it is my
responsibility to insure I have completed the necessary number of hours to complete this course. I am also responsible for
any mistakes in addition on my time cards that
may result in less than the number of hours needed to complete this course. I understand that I will not receive credit for this course
if my time cards do not accurately reflect or meet the number of hours necessary
to complete this class. I also understand
that my supervisor, as designated by my Application (aka Green Sheet) and Objective (aka Pink Sheets), must sign each time card and that no other
person may do so. My Supervisor will also be required to sign and rate my job
performance using an evaluation sheet based on my completion of objectives and work record.
My Supervisor’s name must be signed, on the time cards, in the same way my Supervisor signed my Objective Sheet,
Supervisor’s Letter Sheet, and Evaluation
Sheet. Any time cards or paperwork signed differently (do not use nicknames or
initials) will be not considered valid. I also understand that I will not receive any credit based on incorrectly signed time cards. I understand this may lead
to not completing/ or receiving the number of hours needed to pass this class. I
understand all timecards/paperwork submitted must be original and no photocopies
are accepted. No whiteout, erasure or crossed out, rewritten timecards or paperwork will be accepted. All paperwork
is due on Dec. 10. I understand paperwork is due at that time and failure to have all paperwork turned in and completed may
lead to my not receiving credit in the course.
It is my responsibility to review materials for accuracy and I understand any problems with paperwork
may lead me to failing or receiving no credit in the course.
____________________________________(Print your name)