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Homepage Blank Texas Department Of Aging And Disability Services PDF Template

Form Example

Texas Department of Aging

 

 

 

 

 

 

 

 

 

 

 

 

 

Form 1731

and Disability Services

 

 

 

 

 

 

 

Consumer Directed Services

 

January 2007

 

 

 

 

 

 

Employee Work Schedule and Assigned Tasks

 

 

 

 

 

Employee Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

Purpose of Form:

 

 

Activity Involved:

 

 

 

 

 

 

 

 

 

Initial

 

 

 

 

Tasks

 

 

 

 

 

 

 

 

 

Change

 

 

 

Schedule

 

Effective Date:

 

 

Schedule I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Schedule I – Tasks

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Day

 

 

Time

 

Time

Time

Time

Time

Time

Total

 

 

 

 

 

In

 

Out

In

 

Out

In

Out

Hours

 

 

 

 

 

 

 

 

 

 

 

 

 

Sunday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Monday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tuesday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wednesday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thursday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Friday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Saturday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weekly Total Hours

 

 

 

 

 

Schedule II

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Schedule II – Tasks

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Day

 

 

Time

 

Time

Time

Time

Time

Time

Total

 

 

 

 

 

In

 

Out

In

 

Out

In

Out

Hours

 

 

 

 

 

 

 

 

 

 

 

 

 

Sunday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Monday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tuesday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wednesday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thursday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Friday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Saturday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weekly Total Hours

 

 

 

 

 

 

 

 

 

Acknowledgment of Work Schedule and Assigned Tasks – Sign and Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature – Employer

 

 

 

 

 

Date

 

 

 

 

Signature – Employee

 

Date

Common mistakes

  1. Incomplete Information: Failing to fill out all required fields can lead to delays. Ensure that every section of the form is completed, including the employee name and the effective date of the schedule.

  2. Incorrect Dates: Double-check the dates entered for the schedule. An incorrect effective date can cause confusion about when the tasks are supposed to start.

  3. Missing Signatures: Both the employer and employee must sign and date the acknowledgment section. Without these signatures, the form may not be considered valid.

  4. Inaccurate Time Entries: Entering the wrong times for when employees clock in and out can create issues with payroll. Review these entries carefully to ensure they reflect actual hours worked.

  5. Not Specifying Tasks: Clearly outline the assigned tasks for each schedule. Vague descriptions can lead to misunderstandings about job responsibilities.

  6. Failure to Review Weekly Totals: Make sure to calculate and verify the total hours for each schedule. Errors in totals can affect payment and scheduling.

  7. Neglecting to Update Changes: If there are changes to the schedule or tasks, it is crucial to update the form accordingly. Failing to do so can result in confusion and miscommunication.

Key takeaways

When filling out the Texas Department of Aging and Disability Services form, there are several important points to keep in mind. This form is essential for managing employee work schedules and assigned tasks in consumer-directed services. Here are key takeaways:

  • Understand the Purpose: The form is designed to outline the work schedule and tasks assigned to employees providing care services.
  • Employee Information: Clearly write the employee's name at the top of the form to ensure proper identification.
  • Initial Tasks: Specify the initial tasks that the employee is expected to perform. This clarity helps in setting expectations.
  • Schedule I and II: Use both Schedule I and Schedule II sections to detail different tasks and hours for the employee. This allows for flexibility in scheduling.
  • Day and Time Entries: Fill in the days of the week along with the specific times the employee will work. Accurate entries are crucial for tracking hours.
  • Total Hours: Calculate the total hours worked each week. This total is important for payroll and compliance purposes.
  • Acknowledgment Section: Both the employer and employee must sign and date the acknowledgment section to confirm the work schedule and tasks.
  • Keep Copies: After completing the form, retain copies for both the employer and employee records. This helps in case of any disputes or clarifications needed later.
  • Review Regularly: Periodically review and update the form as needed, especially if there are changes in tasks or schedules.

Steps to Using Texas Department Of Aging And Disability Services

Completing the Texas Department of Aging and Disability Services form is essential for managing employee work schedules and assigned tasks. Follow these steps carefully to ensure all information is accurately recorded.

  1. Begin by filling in the Employee Name at the top of the form.
  2. Identify the Effective Date for the schedule.
  3. For Schedule I, enter the days of the week from Sunday to Saturday.
  4. For each day, fill in the In and Out times for each task, ensuring to record the total hours worked.
  5. Calculate the Weekly Total Hours for Schedule I and write it at the bottom of the schedule.
  6. Repeat steps 3 to 5 for Schedule II, entering the same information as in Schedule I.
  7. After both schedules are completed, move to the Acknowledgment of Work Schedule and Assigned Tasks section.
  8. Have both the Employer and Employee sign and date the form to confirm the schedule.