Discovery Summary

Discovery Facilitator:

Agency Provider:

Participant:

Start Date:Completion Date:

Discovery is…

a process that involves getting to know people before we help them plan
spending time with people, instead of testing or evaluating them, as a means of finding out who they are
an effective way to find out the best that people have to offer
enhanced when we get to know people in settings where they are most who they are
a way to identify the unique contributions offered by persons who might not compete as well as others
not a plan, but the foundation of all person-centered planning that seeks to customize outcomes for people
compatible with self-determination and choice

This form is used to plan your steps and as you implement Discovery. It records the major events and observations of Discovery. It is meant to be a “Living Document”.

NOTE: Discovery is not a linear process. The template need not be used sequentially. Information obtained should be entered into the various sections as it is obtained. Please remember this is about information. Feel free to update this when needed, being sure to insert any new/updated information into the form fields WITHOUT overwriting or erasing the original information you entered. Please keep in mind that quality recording of information includes having more verbs than adjectives.It describes the development and observations of activities in order to learn more about the communication, interests, skills and abilities of the participant.

Part1

Part 1a: Participant’s Identification Information

Date of birth: __/__/___
Address: ______
Phone: Cell:Other:
Agency providing Discovery:
Case manager/agency:
Additional agencies involved with the participant:
Guardian:
Phone ____ - ______
E-mail:

Family Contacts:
Phone ____ - ______
E-mail:

Public benefits:

Work/Internships/Volunteer/Entrepreneurial Experiences (list from most recent)

Business / Dates / Job title / Pay / Tasks Performed

Part 1b: Introductory Interview___

This section includes RELEVANTinformation from a collaborative interview/conversation with Family/Staff, Guardians, Case Mgr.

The following are suggested areas to obtain information on:

Typical routine (weekday & weekend):

Medical conditions & needs:

What are the parametersand/or conditions necessary for successful employment and community inclusion:

Specific chores & tasks participant performs at home:

Without being asked:

Task done for others out of the home:

Family, friend, & non-paid people with whom the individual engages regularly:

Non-structured community activities: (hiking, movies, coffee shops, sports, etc.)
Professional & nonprofessional associations, community club/memberships, religious affiliations:

Skills & tasks Participant:

Can do with support:

Can do without support:

Appears to enjoy:

Would like to learn:

Participant’s contributions: (what are their best qualities?)

What are the conditions that work best for the Participant at home?

What are the conditions that workbest for the Participant in the community?

Communication skills:

How the Participant communicatesbest:

Who the Participant communicates with best:

Expressive communication:

Receptive communication:
Communication nuances: (non-verbal cues, gestures, body language, facial expressions, etc.)

Communication strategies: (receptive and expressive)

Overall Educational Experiences: (as appropriate)
Community Recreational Instruction and/or Experiences:

Vocational Experiences:

Expressed, observed, and/or demonstrated Vocational Interests:

Part 1c: Home & Neighborhood Observation

This section includes RELEVANTinformation not only from interviews and conversations but from your observations.

In EACH section, please add information with as much detail as possible. The field will provide you with enough space to do so, and/or please attach notes, photos, videos, etc.

Date of home visit:

Those present at the home visit:

Housemates, family members, staff in the home:

Observations of home, bedroom, yard, property, belongings that seem relevant:

Supports needed to be successful at home:

Neighborhood Mapping: Resources, stores/shops, businesses/employers, transportation options, neighbors of interest, activities, civic engagement, general description of the neighborhood and surrounding areas.
This can be done in 1 paragraph to include the following:

Description of neighborhood:

Location of neighborhood in community:

Transportation used by the participant and family/staff:

General commercial areas near home (shopping, industry, or services):

Information in this tool was adapted from Marc Gold & Associates, and Griffin Hammis & Associates.

Planning Tool for Facilitator’s Use:

Info Needed/Reason for Observation / Interview or Observation Activity / Target Date / Done

Information in this tool was adapted from Marc Gold & Associates, and Griffin Hammis & Associates.

Part 2

Part 2a: Others to be Interviewed

In EACH section, please add information with as much detail as possible. The field will provide you with enough space to do so, and/or please attach typed notes.

Planning Questions:

What information is needed that might come from these interviews?

What needs clarifying?

Who might have this information?

Name:

Relationship/role:

Date of Interview:

Notes Summary:

Name:

Relationship/role:

Date of Interview:

Notes Summary:

Name:

Relationship/role:

Date of Interview:

Notes Summary:

Name:

Relationship/role:

Date of Interview:

Notes Summary:

Name:

Relationship/role:

Date of Interview:

Notes Summary:

Planning Questions:

What places, skills, and activities need exploration?

Where/when will this exploration occur?

Planning Tool for Facilitator’s Use:

Info Needed/Reason for Observation / Interview or Observation Activity / Target Date / Done

Part 2b: Discovery Observations/Familiar Activities

Identify approximately five places where this individual can be observed in familiar activities that will provide information about their Interests, Talents,Skills & Contributions – Take Photos and/or Videos if allowed.

______