The following forms are in Acrobat PDF format.
If you don't have Acrobat Reader, you can download it here.
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Disciplinary Policies
SYH Clothing Policy
- signed and dated by client.
SYH Disciplinary Policies
- signed and dated by client and P.O. or Caseworker.
SYH House Rules
- signed and dated by client, P.O. or Caseworker and SYH.
SYH Removal and Discharge Policy
- signed and dated by client, P.O. or Caseworker and SYH.
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Education Book
Sweeney Youth Home Resident School Progress Report
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Identification
Identification and Emergency Info form (LIC 601)
- completed, signed and dated by client and P.O.
SYH Admission Agreement
- signed and dated by both parties. Agency-Group Home Agreement form (SOC 154); provided by referring agent.
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Job Descriptions
Administration Assistant Job Description
Assistant Facility House Manager Job Description
Child Care Supervisor Job Description
Child Care Worker I Fulltime Job Description
Child Care Worker I Part time Job Description
LCSW and LMFT Job Description
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Medical Book
Centrally Stored Medication and Destruction Record (LIC 622)
Consent for Medical Treatment form (LIC 627)
- complete, sign and date by client and P.O.
Immunization Records
Over the Counter Medication Log
Physicians Report Form (LIC 602)
- to be provided to Physician when resident goes for medical care or physical exam.
Sweeney Youth Homes Dental Exam/Visits Record
Sweeney Youth Homes Medical Exam/Visits Record
Sweeney Youth Homes Medical Log Table of Contents
SYH Resident Medical Information Form
- complete, sign and date by client and P.O.
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Misc Forms
Letter to Resident
Why Sweeney Youth Homes?
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Needs and Services
Needs and Services Plan (LIC 625)
- to be discussed with resident, initialed and dated.
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Personal Rights, Property and Grievances: Resident and Family
Client/Resident Personal Property and Valuables Form (LIC 621)
- complete on admission.
Grievance Form for Residents
Notifications of Parents Rights Form (LIC 995)
Personal Rights (LIC 613a)
- signed by client and P.O. or Caseworker.
Record of Client/Resident Safeguarded Cash Resources Form (LIC 405)
- complete on admission.
SYH Family Therapy Contract
- signed and dated by client, Family members, resident and SYH agent.
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