Form Weekly Time Summar Weekly Time Summar Weekly Time Summary

PCAP

Weekly Advocate Time Summary
Agency Name: ___________________________

Site Name: ______________________________

Advocate #: __ __ __

Date: __ __ / __ __ / __ __ __ __
Code all time fields in decimal format.
Use leading 0’s where applicable.

DECIMAL CONVERSION
CHART

15 minutes = .25
30 minutes = .50
45 minutes = .75
1 hour = 1.00

Week beginning: __ __ / __ __ / __ __ __ __
Time spent with clients:
These 3 columns should add up to ALL time spent WITH
client this week (in person and on the phone)

A.
FAMILY ID

B.
# VISITS
PER
WEEK

C.
FACE TO FACE
TIME

D.
TRANSPORTING
TIME
(OF CLIENT)

E.
PHONE CALLS
WITH CLIENT

1

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2

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F.
OTHER TIME SPENT ON BEHALF OF CLIENT

G.
for
OTHER

H.
TOTAL
FOR CLIENT

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(TOTAL TIME WITH EXTENDED NETWORK, AGENCIES, CORRESPONDENCE)

BRIEFLY NOTE WHAT BELOW AND AMOUNT OF TIME TO RIGHT

21a. Supervision time—Face to Face:

__ __ . __ __

21b. Supervision time—Telephone:

__ __ . __ __

22. Staff meeting/retreat:

__ __ . __ __

23. Time spent doing paperwork:

__ __ . __ __

24. Transportation time (as part of job; not with client, not to & from work):

__ __ . __ __

25. Informal consultation (specify with who and about what on next page):

__ __ . __ __

26. Community meetings (specify name on next page):

__ __ . __ __

27a. Trainings given (specify name, location, date on next page):

__ __ . __ __

27b. Trainings received (specify name, location, date on next page):

__ __ . __ __

28. Other (specify what on next page):

__ __ . __ __

29. TOTAL: Number of hours worked this week

__ __ . __ __

10/4/2006
Page 1

© 1999, Washington State Parent-Child Assistance Program (PCAP)

Advocate #: __ __ __

Date: __ __ / __ __ / __ __ __ __

DETAILS ABOUT OTHER ACTIVITIES:
25. Informal consultation:
With who:

________________________________________________________________________

About what: ________________________________________________________________________
26. Community meetings:
Name:

________________________________________________________________________

27a. Trainings given:
Name:

________________________________________________________________________

Location:

________________________________________________________________________

Date:

________________________________________________________________________

27b. Trainings received:
Name:

________________________________________________________________________

Location:

________________________________________________________________________

Date:

________________________________________________________________________

What?

________________________________________________________________________

28. Other:

________________________________________________________________________

SUMMARY & FLEX TIME RECORD
30a. Number hours actually worked this week (from Row 29)

__ __ . __ __

30b. Sick hours claimed this week

__ __ . __ __

30c. Vacation/Holiday hours claimed this week

__ __ . __ __

31.

TOTAL:

__ __ . __ __

Number hours you are contracted to work each week

__ __ . __ __

32.

This number will not change, it is the number of hours you were hired to work each week; e.g., if you are full-time, enter “40.00.”

Be sure that Rows 30a+30b+30c = Row 31

__________________________________

__ __ /__ __ /__ __ __ __

__________________________________

__ __ /__ __ /__ __ __ __

Advocate’s Signature

Date

Supervisor’s Signature

Date

10/4/2006
Page 2

Parent-Child Assistance Program (PCAP)