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Unformatted text preview: Student Internship Record Record of Field Placement Agency Name Telephone Agency Mailing Address City State Zip CTRS Supervisor Supervisor’s Title Supervisor’s Certification No Supervisor’s Certification Expiration Date First month/day/year of placement Final month/day/year of placement / / / / Total Weeks X Hours per week = TOTAL HOURS Type of Agency Primary Population Served Important NCTRC Information Visit www.NCTRC.org or contact NCTRC to obtain a copy of the Certification Standards. The Certification Standards contain all of the information you need regarding certification, exam information, and application forms. Keep these documents in this folder: Copy of Supervisor’s CTRS Certification Card Copy of University / Agency Contract Copies of Mid-term and Final Evaluation Copy of the NCTRC Job Analysis Tasks and Knowledge Areas Copies of Internship Reports or Projects sent to the University NCTRC I Student Internship National Council for Therapeutic Recreation Certification 7 Elmwood Drive New City, New York 10956 Tel 845-639-1439 Fax 845-639-1471 email nctrc@NCTRC.org www.NCTRC.org Contact: Task Domain Date of Exposure A. Professional Roles and Responsibilities 1. Establish/maintain therapeutic relationship 2. Create/maintain a safe/therapeutic environment 3. Maintain CTRS credential 4. Participate in in-service training/staff development 5. Maintain knowledge of current TR/RT standards 6. Enhance professional competence 7. Adhere to professional standards/code of ethics 8. Participate in quality improvement process 9. Participate in agency/professional committees B. Assessment 10. Request/secure referrals 11. Obtain/review pertinent information 12. Select/develop assessment methods 13. Conduct assessments 13....
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This note was uploaded on 09/08/2010 for the course HRTM 170C at San Jose State University .