Time Sheet

  • Please complete one sheet for each month and submit by the 5th day of the month following the month of activity.

  • Child’s Name Date Contact Codes Activity Codes Time Spent (1/4 hour) Mileage (for your records) Summary (one sentence description)
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
  • Contact Codes: 1-Face-to-Face, 2- E-mail, 3- Phone, 4- Written, 5- Other

    Activity Codes: 1-Child contacted, 2- Biological parents contacted, 3- Relatives contacted, 4- Foster parents contacted, 5- Case Manager/GAL contacted, 6- Collaterals contacted (schools, counselor, childcare, etc.), 8-Attended FST, 9- Attended court hearing, 10- CASA office contacted, 11- Wrote reports, 12- Other (review files)

    Summary: Summary should include brief one sentence description of interaction.

  • Continuing Education (identify training completed, including time spent to the nearest 1/4 hour)

  • Should be Empty: