Page 1 - Essential Life Skills - #1 Building Relationships - Assessment
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#1– BUILDING RELATIONSHIPS ASSESSMENT

               Client’s Name: _______________________                Today’s Date: _________________
               Case Manager: _______________________


               Assessment Checklist
                   Check the box for each of the following knowledge, skills, and/or abilities (KSAs) the client has
                   successfully demonstrated.

                   From Pamphlet:                                Additional Content in Instructor’s Manual:

                    Discuss the importance of building           Explain the importance of self-esteem in
                       appropriate relationships.                    developing good relationships.
                    Explain what to look for in trusting         Identify ways to rebuild trust with family and
                       relationships.                                friends.
                    Describe what is involved in a “good”        Identify when to let a relationship go, and
                       relationship.                                 when to work on strengthening it.
                               ©2022 Learnovation®, LLC
                    Identify key aspects of parenting.           Identifying when you can impact a
                    Discuss how to handle making mistakes.          relationship in a positive way.
                    Identify positive traits about themselves.
                                           For Evaluation Only


               Skill Level Assessment
                   Directions: Circle the appropriate column to indicate what skill level the client has reached.
                                                                              Mastery (M)
                                                       Practicing (P)
                                 Awareness (A)
                                                                           “Expert at this skill”
                                                    “Practicing this skill”
                                “Trying this skill”
               From Pamphlet:                     Skill List                                    Skill Level
               Identify personal strengths when relating with people.                            A / P / M
               Develop a plan for improving current relationships.                               A / P / M
               Distinguish characteristics of a good friend from a bad friend.                   A / P / M
                Additional Content in Instructor’s Manual:
                Identify issues in current relationships and develop a strategy for improving them.   A / P / M
                Acknowledging personal self-worth.                                               A / P / M




               I, _________________________ have completed all necessary reading and exercises related to
               the Essential Life Skill Series pamphlet, Building Relationships. The case manager and I have
               reviewed all the above items that required discussion.







               _____________________________                         ___________________________
                              Client’s Signature                                  Case Manager’s Signature






               Building Relationships – LS1                                     Essential Life Skills Pamphlets
               ©2022 Learnovation®, LLC
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