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HomeMy WebLinkAboutSupporting Documents(attachment VI A, supporting documents) Jeb Bush, Governor Shelly Brantley, Director District 11 Office 401 N.W. 2nd Avenue, Suite South 821 Miami, Florida 33128 (30S) 349.1478 Fax: )305) 349-t479 agency for persons with disabilities State of Florida December 10, 2004 United Cerebral Palsy of Miami Attn: Pam Mil.'ler 1411 N.W. 14t Ave. Miami, FL 33125 Re: Approval to conduct Supported Employment Pre -service Training Dear Ms. Pam Miller: Thank you for submitting United .Cerebral Palsy o€ Miami's proposed Supported Employment Pre -service tramtng,curn alrii ngmethods, 'objectives, and training agenda. The district and Centr O haveieyre i ertl , dot ents and determined that United Cerebral Patsy of ami is abl to prc3 ide the upporied Employment Pre - service training to their'o eii Please inform the department rf afiy c an es occur'in the tramu% a change of trainers (some ryoursclf n a.Iddit, department with the names ofal, oyees t complete the; i If you have any questions Sincerely, Lisa L. Friedman -Chavez Supported Employment Coordinator cc: J.B. Black composition, including ;eprovide the training. 05) 37.7-7281. --4 --4 • ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ • ■ ■ ■ • ■ ■ ■ ■ ■ ! ■ ■ ■• This training was approved by the Developmental Disabilities Program Central Office for Florida supported employment providers in the Developmental Services Program. Certificate of Completion Orientation to Supported Employment This is to document that Parri Miller ha,s completed 18 hours of training on June 21-23, 2004 in hliami Florida Presented by: Dale DiLeo, Lead er ■ TRAINING RESOURCE NETWORK`. PO BOX 439 • ST. AUGUSTINE, FL 32085-0439 904-824-7121 • FAX: 904-823-3554 • info@trninc.com • http://www.trni:nc.com Trainer's ' ure ame itifrft rovider Medicald Number: 024970096 noted Cerebral Palsy Association of Miami, agency for persons with disabilities State of Florida 6/28/06 Date Miami -Dade College Presented by Kathy March 23, 2005 11:00 a.m.-12:00 p.m. 2�: i; r r Lisa Friedman -Chavez Developmental Disability Program ro© bilities • • IN • • • • • • • • NI • I X • XXXX nal X X • Certificate of Completion II II X This training provides 18 hours of on-line pre -service or continuing education training in the following topic: Orientation to Supported Employment This is to document that: Essen Jackson -Carter United Cerebral Palsy Miami has successfully completed the requirements of the web -based training curriculum: Oct 2005 Presented by: Dale DiLeo, Lead Trainer TRAINING RESOURCE NETWORK • PO BOX 439 • ST. AUGUSTINE, FL 32085-0439 904-824-7121 • FAX: 904-823-3554 • info@trninc.com • http://www.trninc.com ��i:t3xi���I��£ ���fe 1 : z��E 3:<£�z s vja r <ik��=`s3F�?si 3�"�� u �S: ;:a�� z'f ��`�i: : t �� srs . • F s° "� $ '. 23 3 s o This is to certify that Essen JacksonCarter has successfully completed Effective Training at Work Awarded by The National Center for Disability Education & Training University of Oklahoma College of Continuing Education August 3, 2004 Certificate# EJ080304 Vrt 1 l+Lv SYvt. ��5 x�gN g y3 yg ; t #3 ff}}gg.{{z[£8 gg�� �gg ?��; pp��Y b' 3si. 'ts��£�xEvs'��� s�w..,�.,,:�:���f33:Ez},�s.�3l3,3���E33;ff���i3:%e« Trainer's ure/Name rovider 024970096 nited Cerebral-Palt.-:-Asd61atiOn of Miami, Inc. 6/20/06 Offide Date • • a agency for persons with disabilities State of Florida 111 III II a l • torida NETWORK University of Florida - Department �of Special Edution 'This is to Certify that 9 • son has completed gaining in Oiientgtjon to Supported Employment Hollywood, Florida September 15 - 18, 1998 kaa Sup rted Employment Pro ect C rdinator F etwork lrector This training is funded in part by the Florida Department of Education. • —4 —4 --e --4 --4 —4 . A , - '' - . �.., -. _,. s s`, � "�T ti;• i 4L-�s,zi - -fs `S 1 .3 �� rl1l This training wqs approved by the Developmental Disabilities Program Central Office for Florida supported employment providers in the Developmental Services Program. Certificate of Completion Orientation to Supported Employment This is to document that S ami Lerner has completed 18 hours of training on June 21-23, 2004 in Miami. Florida Presented by: Dale DiLeo, Lea i ainer ■ TRAINING RESOURCE NETWORK • PO BOX 439 ■ ST. AUGUSTINE, FL 32085-0439 904-824-7121 • FAX: 904-823-3554• info@trninc.com • http://www.trninc.com 1 4 f, i ', 1 s I i; $ '� 1 l ,�,j i s !, 3 1t r _ J��LILIIIIIi'I�lIIII�I�I.Iy141I�I,Ia111IIILLI,II,{ l l,llll�l I-II.I.IIIIIsIJ { llllll:{�I.I9I�II�1{.I;IIIIbf-{I,I II1IIIhLI=I�II9I41�1�IIII4IIII.IIIIC�l:I�{fih{.111Ii1E1�1�IaIIiIC�{�IEIllfhl�l,1,i{i{f�{'fLlil�{9fllill�{�1�11�f!{:{.�{�il4ifl;f�i�11{{'{ 11{�II�II�- 7-7 This is to certify that Sami Lerner has successfully completed ffec*ive Training at Work Awarded by The National Center for !Disability tdUCetian C 'raining University of Oklahoma College of Continuing Education April 8, 2004 Cettiticate# SLb40804 7,77 ;��(III:IIIII:I�Illlliila�1:1911III1 I�LII111Li�IIIlililla1116IIf1�11.19LII IIIIIhl91131�IIiIIL�II€I�IIII!I(°Illlilli131IIIIIIIEI I-IJIII.I LIIlfslll II�IIIIIIII.Id;III{:I�I'tfSllhhlIlull[III'I�IIIIII:P'IIII(ILI.! I�I11}iIII�I',I�IIII'I`IIII1pIII:Llllflill;l Ir August 24 & 25, 2006 Boca Raton, Florida The 8th Annual Conference Florida APSE - The Network on Employment "Employment for All Start a Revolution" Certificate of Attendance Presented to: Saninii tenier Vnitet' Cerebral Palsy of Miami Mich F. Capps, President Trainer's aiure/Narne Area Office Number a agency for persons with disabilities State of Florida 6/20/06 • Date Sami Lerner From: Sami Lerner Sent: Wednesday, May 02, 2007 5:09 PM To: Sami Lerner Subject: FW: Bounced emails From: Dale DiLeo [mailto:trn(lfastmail.us] Sent: Thursday, March 08, 2007 10:02 AM To: Sami_Lerner@yahoo.com Subject: Bounced emails Dear Olivia Henry, Congratulations, you have been accepted into the course. Unless you have applied for and received a waiver, your payment or PO has been processed. Your User Name and Password have now been entered into the administration database. You will need both name and password to log on to the course. The User Name you chose at registration is: OliviaH If you have forgotten the password you chose at the time you registered, you may reset it using the procedure described at: http://www.flse.net/forum/password.asp If you have not yet done so, please review the technical requirements page before beginning. It can be found at: http://www.flse.net/Entry/technical.html To enter the course on the start date, please bookmark: http://www.flse.net/entry/entry.asp If for any reason you now find you are unable to participate, please inform the instructor at daled(aiflse.net as soon as possible. Thank you, Dale DiLeo 00 ,vA mat 1 C� �\ C'q k 1 This is to certify that Olivia Henry has successfully completed Effective Training at Work Awarded by The National Center for Disability Education & Training University of Oklahoma College of Continuing Education January 24, 2007 Certificate# OH012407 Provider Medicaid Number: 024970096 Agency: United Cerebral Palsy of Miami, Inc For co nptetin9 t(i.e Gp trainin9 related tv Direct &are Goynpetencies Training f<eq sired tke Medicaid waiver Services A-9reejnent I affirm that I have completed the training and understand and acknowledge that if I provide false information in this affirmation, I will have breached the Medicaid Waiver services agreement between APD and myself, and will be subjected to fines and penalties• as provided in the agreement. %! i/ /46 D.aJ plo)yee' 1inature V Date :::::.::.. �:::.::::.:::!:isv ::.:::::...................... ::.: ..:....:::v::..........::;•n::.n::.:.::.r.x:::;•.n:v,:w .•n•.�: •:}::: nv.:::..:.: n::;wx; x; ::,:; •:::::.:.: �:v:n::.;,:.:: n..r;.v.;;:: x.:iiY;• ..... �e...h ..tee ?,::.a.aa:r:...::...�.._se::.::.::::::::.::::::.....�.....,. :.. :.k„Y.,:.:.::c _:.�,:a'>::_ ::�.:v::::.•..•: _,_..._.:::::•:::t'o:^:n::;Y ��........a.�.�........a.�.®___..�.f�.t........�a®.r...r..,aa�.a.-._....�.a.••�er.......�e�.ec..-.. ___ - tip.-:....:. .....:::.::..: :. ....: Certificate anct Af firynation of Cvtr ptetion Agency: United Cerebral Palsy of Miami, Inc For coynptettiny tf.e CP training retate4 to Direct Care Cvfn,petencies Training Xetuirect i,s/ tke 1Keeticai4 Waiver Services A-greefnent I affirm that I have completed the training and understand and acknowledge that if I provide false information in this affirmation, I will have breached the Medicaid Waiver services agreement between APD and myself, and will be subjected to fines and penalties as provided in the agreement. r '��•:Nx . •:..r:..::•; •..::: • • :: :• :•:; •.•:: x. �:.tv::::.v.•NN: r :. .:.. ♦ ...• ::... v.vv::::::.:•r.•: .:.::.•:.::: x.• :..:,.:.... . .... .... .... 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