ABC SKILLS
SHIFT CHANGE- TRANSFER
Location
Please Select
Asher House
Shoulder's House
On-Coming Staff Name:
Date
/
Month
/
Day
Year
Date Picker Icon
Shift Start Time
Hour Minutes
AM
PM
AM/PM Option
Out-Going Staff Name:
Date
-
Month
-
Day
Year
Date Picker Icon
Shift Start Time
dles Minutes
AM
PM
AM/PM Option
Number of Cordless Landline Phones Transferred
Staff Initials for Number of cordless phones transferred:
Number of Youth Cell Phones Transferred:
Staff Initials for Number of Youth Cell Phones Transferred:
Number of Asher/Shoulders House key sets transferred
Staff Initials for Number of Key Sets Transferred:
Staff transferred business debit card
YES
NO
Staff received business debit card
YES
NO
Staff transferred cash: Amount $
Staff received cash: Amount $
Indoor/Curbside Garbage containers out/emptied (if applicable)
YES
NO
All exterior doors locked
YES
NO
Condition of Facility during Transfer
Facility Clean and No Damages
Facility Not Cleaned
Property Damage
Other
Facility Notes
*
Signature
Print Form
Submit
Should be Empty: