Job Services Details
StaffTya Quinn
Individual NameSamuel White
Date03/02/2026
Start Time08:00 AM
End Time11:00 AM
Goals & Progress
Goals
Row ID Goal Goal Achieved
1 Mr. White will maintain his employment by completing all his assigned tasks with verbal reminders through 12/31/2025. Yes
Assessment
Refused to work and why? Was another job done in place of this?No he did not refuse to work. After arriving to work and clocking him in it stated on the time that he wasn't scheduled for the day but it did clock him in for his shift
Did the person arrive on time, if not why?NO he did not arrive on time, he arrived at 8:30 am and clocked in at 8:37 am. The driver stated that the forms I am to sign for his pickups have a different time stated on there from 9 am to 12 pm although he stills drops him of and picks him up between 8 am and 11 am and stated that there is a miscommunication because as he states the government is aware of the 9 to 12 hours and if the store manager at Sammy job was going to change the shift that he needed to make everyone aware of the changes so that the transportation system would have the correct hours.
Was the person appropriately dressed, if not why?Yes he was dressed in a black long sleeve button collared shirt with blue faded Dickie pants and a brown belt. He also had on black and white tennis shoes, a red spiderman winter hat and a blue winter coat on
What duties were performed today?He cleaned all numbered aisles, the front cashier and checkout areas along with the bathroom entrance. He swept the floral department and the cheese all around the world area. He cleaned the self checkout areas near the Starbucks side and the dining area
Assessment Continued
Did person have all necessary items to perform job duties?Yes we originally couldn't find his broom with his name on it so we asked the supervisor of receiving and they issued him a new broom and said we can keep it in their office to keep people from taking it and using it since he has a specific preference from what type of broom he uses to complete his tasks for the day
Did the person interact positively with coworkers?Yes he interacted well with co-workers and customers
While working, did person take initiative to move on to another task without prompting?He knows where he wants to clean and he will direct me to those areas with him and I assist him today with holding the dustpan so he can sweep the entire areas properly
Were there any incidents/health related issues/medication side effects or concernsNo incidents to report at this time
Comments, Office/DDS Follow UpWhen clocking him in he was not on the schedule today. I asked his manager when does he put out the schedules and usually he does it by one o'clock on Fridays but Sammy leaves at 11 am, thus not being aware if he is or isn't on the schedule till the following Monday when he comes in. It's noted that his schedule is always Mondays Wednesdays and Fridays so I do not know what prompted him not being on the schedule
Risk Assessment MonitoringAt risks for falls and collisions when he is hyperfocued on his tasks
Report Signature
Reporting Location Address1100 4th st. SW
Washington, District of Columbia
Map It
Signature
Share this Listing

Enter an email address and a PDF of this listing will be sent as an attachment.

This field is for validation purposes and should be left unchanged.
This field is hidden when viewing the form
This field is hidden when viewing the form
This field is hidden when viewing the form
This field is hidden when viewing the form