Apprenticeship Program Self - Assessment Review

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Department of Industrial Relations Division of Apprenticeship Standards Apprenticeship Program Self - Assessment Review and Program Improvement Plan These forms are provided to assist apprenticeship programs to comply with: California Code of Regulations Title 8, Article 4, Section 212.3 * Apprenticeship Program Self-Evaluation and Monitoring Section 212.3.b The Self-Assessment Review and Section 212.3.c The Program Improvement Plan. These forms can be used as is, or as a guideline to produce your own documents that contain the re uired information. * A copy of the Regulation is available on the internet at www.dir.ca.gov/t8/213_3.htm or from your local DAS Office.

DAS 2123 (4-07) Department of Industrial Relations Division of Apprenticeship Standards PROGRAM NAME PROGRAM ADDRESS OCCUPATION(S) DATE OF THIS REVIEW PERIOD OF THIS REVIEW DATE OF LAST SELF - ASSESSMENT REVIEW DATE OF MOST RECENT PROGRAM IMPROVEMENT PLAN PERSON(S) PREPARING THIS REVIEW LOCATION(S) OF RELATED SUPPLEMENTAL INSTRUCTION NAME AND ADDRESS OF LOCAL EDUCATION AGENCY DAS CONSULTANT(S) FOR PROGRAM During the period covered by this review, the number of new apprentices Indentured is: During the period covered by this review, the number of apprentices who graduated is: During the period covered by this review, the number of apprentices who terminated is: At the end ... more. less.

of the period covered by this review, the number of active apprentices is: ACCEPTED AND APPROVED BY - NAME AND TITLE SIGNATURE DATE DAS 2123 (4-07) PAGE 1 OF 7 Apprenticeship Program Self - Assessment Review Program Sponsor I certify that the Self-Assessment Review was conducted in good faith, and I declare under penalty of perjury that the Information contained herein is true and correct to the best of my knowledge and belief. Department of Industrial Relations Division of Apprenticeship Standards A. OUR OBJECTIVE A. OUR OBJECTIVE B. REVIEW QUESTIONS YES NO B. REVIEW QUESTIONS YES NO 1. Was course material reviewed during this period? 1. Is the performance of the Instructors being monitored? 2. Does the curriculum currently cover all work processes? 2. Is there a procedure to monitor OJT hours and related Instruction hours? 3. Does the curriculum relate to appropriate Industry standards? 3. Has the Committee reviewed the performance of the apprenticeship coordinator(s)? 4. Does the program curriculum need to be updated? 4. Does the program and staff have adequate record keeping procedures? 5. Has the program curriculum been updated? 5. Is there a responsible party for record keeping? 6. Are the instructors complying with the lesson plans? 6. During this period, have you conducted an employer orientation workshop? 7. Were the Instructors lesson plans reviewed during this period? 7. Did the DAS audit your program during this period? 8. Do the curricula text and hand-outs need modification or update? 8. Has the DAS recommended any changes in your program? 9. Was there instructor training on curriculum? C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: DAS 2123 (4-07) PAGE 2 OF 7 Apprenticeship Program Self - Assessment Review I. Curriculum and Instruction II. Supervision and Management Department of Industrial Relations Division of Apprenticeship Standards A. OUR OBJECTIVE A. OUR OBJECTIVE B. REVIEW QUESTIONS YES NO B. REVIEW QUESTIONS YES NO 1. Are any tutorial programs available to supplement the apprentices' classroom training? 1. Have the instructors complied with fundamental training course requirements? 2. Does the committee provide Individual apprentice evaluations on a regular basis? 2. During this period did the committee evaluate the Instructor(s)? 3. Are apprentice evaluation procedures being followed? 3. During this period did the apprentices evaluate the Instructor's performance? 4. Does the committee have written procedures for rotating Individual apprentices to ensure complete work process training? 4. Have the evaluations been discussed with the Instructor(s)? 5. Are Individualized study accommodations provided for apprentices? 5. Are there any procedures for ongoing instructor and committee staff training? 6. Have there been apprentice complaints regarding lack of OJT supervision? 7. Is there a method to ensure OJT supervision by competent journeymen? 8. Have the committee members and the coordinator been updated on changes to state apprenticeship regulations? 9. Are Instructors familiar with the program's Rules & Regulations? C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: DAS 2123 (4-07) PAGE 3 OF 7 Apprenticeship Program Self - Assessment Review III. Individual Apprentices Training Plans IV. Competent and qualified personnel Department of Industrial Relations Division of Apprenticeship Standards A. OUR OBJECTIVE A. OUR OBJECTIVE B. REVIEW QUESTIONS YES NO B. REVIEW QUESTIONS YES NO 1. Are the facilities adequate for apprentice training needs? 1. Is there community media exposure about the availability of the program? 2. Is the equipment utilized for classroom training in sufficient supply? 2. Does the program utilize guest speakers from the community on current topics? 3. Is the equipment used on the job site pertinent to the classroom learning experience? 3. Does your program utilize Industry or journey level role models as guest speakers? 4. Is the equipment utilized in the classroom properly maintained? 5. Do all apprentices receive safety training on the equipment utilized in the classroom? 6. Are there any safety problems with the equipment and materials utilized in the classroom? 7. Are the educational course materials in sufficient supply? 8. Are the educational aids and course materials in need of revision? C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: DAS 2123 (4-07) PAGE 4 OF 7 Apprenticeship Program Self - Assessment Review V. Utilization of Facilities, Equipment and Material VI. Community, Business and Industry Involvement Department of Industrial Relations Division of Apprenticeship Standards A. OUR OBJECTIVE A. OUR OBJECTIVE B. REVIEW QUESTIONS YES NO B. REVIEW QUESTIONS YES NO 1. Does the program advertise and make information available in the community about apprenticeship opportunities? 1. Does the program have a plan to promote apprenticeship opportunities? 2. Is the program's recruiting in conformance with the program's Cal-Plan requirements? 2. Does the committee have a budget for promotional activities and advertising? 3. Did the program receive less than the expected number of applications? 3. Did the program participate in any civic functions which enhanced its reputation during this period? 4. Does the program have a sufficient number of subscribing employers to permit consistent on-the-job training for the indentured apprentices? 4. Did the program receive any rewards or accolades during this period? 5. Does the program have an adequate method for the placement of apprentices for on-the-job training? 5. Did the committee engage in any supplemental programs or activities for the promotion of the program? 6. Does the program have a system for the placement of graduated apprentices? 6. Did the committee recognize any outstanding apprentices upon their graduation? C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: DAS 2123 (4-07) PAGE 5 OF 7 Apprenticeship Program Self - Assessment Review VII. Recruitment, Assessment and Placement VIII. Program Promotion Department of Industrial Relations Division of Apprenticeship Standards A. OUR OBJECTIVE A. OUR OBJECTIVE B. REVIEW QUESTIONS YES NO B. REVIEW QUESTIONS YES NO 1. Is the program's record keeping done on a timely basis? 1. Is safety incorporated into course materials? 2. Are all mandated reports being submitted to the required state and federal agencies on a timely basis? 2. Do apprentices receive safety training during their related and supplemental instruction? 3. Are the program's funding sources adequate to meet anticipated financial needs? 3. Does the program require CPR and first aid training as part of the classroom education? 4. Does the program have a mechanism to ensure that apprentice training meets employer needs? 4. Does the program have a substance abuse policy? 5. Do subscribing employers regularly evaluate performance of existing apprentices? 5. Are the apprentices given substance abuse education during their classroom training? 6. Does the program have apprentice completion and apprentice graduation goals? 6. Are apprentices given drug tests by the program? 7. Does the program's completion rate meet the program's expectations? 7. Does the program provide an Employee Assistance Program (EAP) counselor for apprentices? 8. Are apprentice training ratios being adhered to? 9. Does the program have an annual budget for training ? If yes, attach a copy. C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: DAS 2123 (4-07) PAGE 6 OF 7 Apprenticeship Program Self - Assessment Review X. Safety and Drug-free Environmental Training IX. Program Accountability Department of Industrial Relations Division of Apprenticeship Standards A. OUR OBJECTIVE B. REVIEW QUESTIONS YES NO 1. Is recognition of sexual harassment incorporated into course materials? 2. Is recognition of illegal discrimination incorporated into course materials? 3. Do apprentices receive recognition of sexual harassment training during their related and supplemental instruction? 4. Do apprentices receive recognition of illegal discrimination training during their related and supplemental instruction? 5. Does the program have a sexual harassment abuse policy? 6. Does the program have a illegal discrimination policy? C. FROM THE ABOVE QUESTIONS, THE AREAS FOR IMPROVEMENT ARE: DAS 2123 (4-07) PAGE 7 of 7 Apprenticeship Program Self - Assessment Review XI. training in the recognition of sexual harassment and illegal discrimination Department of Industrial Relations Division of Apprenticeship Standards ORDER OF PRIORITY FOR CORRECTION (1,2,3,ETC.) DEFICIENCY (INDICATE CATEGORY NUMBER FROM SELF- ASSESSMENT REVIEW) IMPROVEMENT NEEDED, PLANNED ACTION: RESOURCES REQUIRED TIMELINE FOR COMPLETION (FROM - TO) PERSONNEL RESPONSIBLE DATE COMPLETED DAS (9-93) PROGRAM IMPROVEMENT PLAN Page of Pages Department of Industrial Relations Division of Apprenticeship Standards ORDER OF PRIORITY FOR CORRECTION (1,2,3,ETC.) DEFICIENCY (INDICATE CATEGORY NUMBER FROM SELF- ASSESSMENT REVIEW) IMPROVEMENT NEEDED, PLANNED ACTION: RESOURCES REQUIRED TIMELINE FOR COMPLETION (FROM - TO) PERSONNEL RESPONSIBLE DATE COMPLETED DAS (9-93) PROGRAM IMPROVEMENT PLAN (Cont'd.) Page of Pages

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