NOTIFICATION OF EMPLOYMENT

 

OR ASSIGNMENT OF

 

JUVENILE COURT INTAKE WORKER

 

Pursuant to DOC 399.05, Administrative Code, County Departments of Social/Human Services are required to notify the Department of Corrections when a person has been employed or assigned to perform juvenile court intake worker duties as defined in s. 938.067 and s. 48.067,

WI Stats.  According to s. 938.06(1)(am)1 and s. 48.06(1)(am)1, WI Stats., all intake workers who begin employment after May 15, 1980 shall have successfully completed 30 hours of training provided by the department.

 

Please provide the following information and submit to the Dept. of Corrections prior to the completion of the first six (6) months of employment in the position.

 

1)      Name of Juvenile Court Intake Worker: ______________________________________

 

2)      Employing County Agency: _______________________________________________

 

3)      Date of employment or assignment to perform intake worker duties: _______________

 

4)      Position in the agency (full time or part time):_________________________________

Circle one

 

4a) If applicable please complete the following:

This person works part-time, on-call only 

Number of hours per month on call: ___________

 

5)      Supervisor and phone number:       _______________________________________

___(________)___________________________

 

6)      Check One of the Following:

___This employee is required to complete Basic Intake Worker Training;

___This employee completed the Basic Training on ________________________;

                                                                                                       (Date of certification)

___This employee is exempt from Basic Training because s/he was hired to perform

       juvenile court intake duties in WI prior to May 15, 1980.

 

7)      Comments: ______________________________________________________________

 ______________________________________________________________

 ______________________________________________________________

 

Submit to Michelle Buehl, Juvenile Services Specialist, Division of Juvenile Corrections, P.O. Box 8930, Madison, WI 53708-8930, Phone 608.240.5914, Fax 608.240.3371  

 

July 9, 2001

DOC/DJC/PJE