WTW 2 CHEAT SHEET - Santa Clara County, California



WTW 2 CHEAT SHEET

CORE HOURS

I must do at least 20 “core” hours per week. They are:

| |Unsubsidized employment |for | | hours | |Job search and job readiness assistance |for | |hours |

| |(Full- or part-time employment in the public or private | | | | |(Job Club and full-time/part-time job search. Maximum 6 | | | |

| |sector.) | | | | |weeks per calendar year.) | | | |

| |Subsidized private sector employment |for | | hours | |Vocational education and training (up to 12 months) |for | |hours |

| |(Paid employment in the private sector for which the | | | | |( Available months:       | | | |

| |employer receives a subsidy. This activity replaced | | | | |(Vocational training program other than a baccalaureate or | | | |

| |Paid Work Study, | | | | |advanced degree.) | | | |

| |Paid Internship, | | | | | | | | |

| |Paid Externship.) | | | | | | | | |

| | | | | | |Community service |for | |hours |

| | | | | | |( FLSA hours:       | | | |

| | | | | | |(Supervised volunteer projects that serve a useful community | | | |

| | | | | | |purpose. FLSA calculation (see back side) required. When | | | |

| | | | | | |determining and calculating the FLSA hours for clients on the| | | |

| | | | | | |WTW15, the State Minimum Wage should be used) | | | |

| |Subsidized public sector employment |for | | hours | | | | | |

| |(Paid employment in the public sector for which the | | | | | | | | |

| |employer receives a subsidy. This activity replaced | | | | | | | | |

| |Paid Work Study, | | | | | | | | |

| |Paid Internship, | | | | | | | | |

| |Paid Externship.) | | | | | | | | |

| | | | | | |Work experience |for | |hours |

| | | | | | |( FLSA hours:       | | | |

| | | | | | |(Unpaid and supervised work activity. FLSA calculation (see | | | |

| | | | | | |back side) required. When determining and calculating the | | | |

| | | | | | |FLSA hours for clients on the WTW15, the State Minimum Wage | | | |

| | | | | | |should be used This activity replaced | | | |

| | | | | | |Unpaid Work Study, | | | |

| | | | | | |Unpaid Internship, | | | |

| | | | | | |Unpaid Externship, | | | |

| | | | | | |Bridge – when needed as a stand alone activity for more than | | | |

| | | | | | |one calendar month.) | | | |

| |Self-employment |for | | hours | | | | | |

| |(Additional hours may be required to meet the 32/35 hours | | | | | | | | |

| |requirement. To determine core hours for self-employment, | | | | | | | | |

| |use this formula: | | | | | | | | |

| |$      |(gross |- $       |(business |

| | |income) | |expense) |

| |(Vocational training after 12 months life time limit, or | | | |

| |Classes that required by an employer to provide an individual with the ability to obtain employment or | | | |

| |to advance or adapt to the changing demands of the workplace, or | | | |

| |Remedial classes that required as prerequisites for Vocational Education and Training.) | | | |

| |Education directly related to employment |for | |hours |

| |(Education or training related to a specific occupation, job, or job offer. Limited to clients without a| | | |

| |US high school diploma or certificate of high school equivalency; may include ABE, ESL, or education | | | |

| |leading to GED.) | | | |

| |Satisfactory progress in a secondary school |for | |hours |

| |(Cal-learn and teens.) | | | |

ASSIGNMENT AND SERVICES

(For transitional activities, only complete the Assignment and Services section)

Transitional activities may include: Bridge-when needed for less than one calendar month, Assessment, Keys to Success, Substance Abuse, Mental Health, and Rehabilitation.)

STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

SIMPLIFIED FOOD STAMP PROGRAM UNPAID WORK EXPERIENCE

(WEX) AND UNPAID COMMUNITY SERVICE HOURS WORKSHEET

|GRANT/CALCULATION MONTH (MONTH PRIOR TO THE ACTIVITY |

|PARTICIPATION MONTH) |

|      |

|ACTIVITY PARTICIPATION MONTH |

|      |

Complete this form to determine the maximum number of hours a county may assign an individual to unpaid community service and/or unpaid WEX, up to 32- or 35-hours per week. (Note: A county need not assign an individual all of the hours determined by the formula below). If the assignment is less than 32- or 35-hours per week, the individual is required to participate in other activities to meet his or her work participation requirement.

|PARTICIPANT’S NAME |CASE NO. |

|      |      |

| | |

|Actual Cash Grant Authorized for the Grant/Calculation Month, Including Underpayments and Supplemental | |

|Payments On or Before the 10th of the Month. (After Penalties and Overpayments. Do Not Include Any Amount | |

|Used to Subsidize Grant-Based OJT Community Services.) | |

| |$       |

|Actual Food Stamp Allotment Authorized for the Grant/Calculation Month, Including Underissuances Paid On or | |

|Before the 10th of the Month. (After Overissuance Adjustments.) To determine prorated amount for mixed food| |

|stamp households, use this formula: | |

| | |

| | |

| | |

| |+ $ |

| |Total Household FS Allotment |($      ) |= | |x | | | |

| |# of FS Recipients in Household | (      ) | |(FS | |(# of | | |

| | | | |Amonut/ | |CalWORKs | | |

| | | | |Person | |Recipients | | |

|Total Benefits Paid for the Grant/Calculation Month. | |

|(Total of line 1 and line 2) |=       |

|Monthly Minimum Wage Calculation Amount for the Grant/Calculation Month. (Divide line 3 by the appropriate | |

|minimum wage) | |

|$       ÷ $       | |

|(line 3) (Minimum Wage) |=       |

|Maximum Average Unpaid WEX/Community Service Hours for the Grant/Calculation Month. | |

|(Divide line 4 by 4.33)       ÷ 4.33 | |

|(Round Down) (line 4) |=            |

| | |

|COMPLETED BY |AGENCY |DISTRICT NUMBER (IF APPLICAABLE) |DATE |

|      |      |      |      |

|WTW 15 (12/05) RECOMMENDED FORM | |

|IDM-CWES, F6 | |

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