Neftaly Therapeutic Psychosocial Support Programme
Duty Sheet and Registers Pack
1. Programme Duty Sheet
Neftaly Therapeutic Psychosocial Support Programme
Daily Staff Duty Sheet
| Date | Programme Site | Facilitator Name | Position | Contact Number | Signature |
|---|---|---|---|---|---|
Daily Responsibilities Checklist
| Activity | Time | Responsible Person | Completed (✓) |
|---|---|---|---|
| Client Registration | |||
| Intake Assessment | |||
| Individual Counselling | |||
| Group Therapy Session | |||
| Crisis Intervention | |||
| Family Support Session | |||
| Referral Services | |||
| Case Notes Update | |||
| Monitoring & Evaluation | |||
| Daily Report Submission |
Supervisor Verification
Supervisor Name: _________________________
Signature: _______________________________
Date: ____________________________________
2. Client Attendance Register
Psychosocial Support Attendance Register
| No | Client Name | ID Number | Gender | Age | Contact | Session Type | Signature |
|---|---|---|---|---|---|---|---|
| 1 | |||||||
| 2 | |||||||
| 3 |
3. Psychosocial Screening/Intake Register
| Intake No | Date | Client Name | Referral Source | Presenting Problem | Risk Level | Assigned Practitioner |
|---|---|---|---|---|---|---|
4. Individual Counselling Register
| Session No | Client Name | Session Date | Type of Therapy | Duration | Facilitator | Follow-Up Date |
|---|---|---|---|---|---|---|
5. Group Therapy Register
| Date | Group Name | Topic | Facilitator | No. of Participants | Venue | Outcome |
|---|---|---|---|---|---|---|
6. Crisis Intervention Register
| Date | Client Name | Nature of Crisis | Intervention Provided | Referral Made | Staff Responsible |
|---|---|---|---|---|---|
7. Referral Register
| Date | Client Name | Referred To | Service Type | Reason for Referral | Follow-Up Status |
|---|---|---|---|---|---|
8. Home Visit Register
| Date | Client Name | Address | Purpose of Visit | Findings | Next Action |
|---|---|---|---|---|---|
9. Staff Duty Allocation Register
| Staff Name | Role | Assigned Activity | Area Covered | Reporting Time | Signature |
|---|---|---|---|---|---|
10. Daily Psychosocial Report Register
| Date | Total Clients Served | Individual Sessions | Group Sessions | Crisis Cases | Referrals | Facilitator |
|---|---|---|---|---|---|---|
11. Confidentiality & POPIA Compliance Register
All staff handling psychosocial information must sign:
| Staff Name | Position | POPIA Compliance Signed | Date | Signature |
|---|---|---|---|---|
12. Incident Register
| Date | Incident Description | Client Involved | Action Taken | Reported To | Signature |
|---|---|---|---|---|---|
13. Programme Monitoring Register
| Indicator | Target | Achieved | Evidence | Verified By |
|---|---|---|---|---|
| Clients Supported | ||||
| Counselling Sessions | ||||
| Referrals Completed |
