Completion of Supervision Report
This form should be completed during every Supervision session
Staff member Name
*
First Name
Last Name
Position
Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
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1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Key Performance areas:
1. Strengths and areas of growth:
Nature of evidence (eg. Daily reports, Developmental reports, Home visit reports, Attendance registers, Medication registers, Incident report etc.)
2. Allocated Key children
*
Anele
Ayabonga
Dennis
Enrico
Eric
Esethu
Hlumelo
Johny
Joshua
Kevin/Akim
Khona
Lihle
Mathew
Mluleki
Obert
Patrick
Ronny
Sammy
Siboniso
Sibusiso
Silindokuhle
Steven
Tembela
Thabiso
Thurlow
Other
Important information to report on key children
3. Developmental Programmes
*
Please Select
Yes
No
Dates of last visits and Feedback from Home visits
Actions from Home visit
5. Sport & Recreation Activities - Submitting registers
6. Administer medication.
*
Please Select
Always
Most of the time
Sometimes
Never
Evidence (eg. Medication register)
If No, reasons why? And how this will be done differently
8. Time & Attendance - On time or late coming.
*
Please Select
Always on time
Mostly on time
Regularly late
Always late
If often not on time or late. What is the reasons and how will staff member attempt to change this?
9. Legal requirements - Does all key children have an IDP?
*
Please Select
Yes
No
If No, by when will it be completed?
Legal requirements - Does all key children have a Exit plan and Careplan?
Yes
No
If No, by when will it be completed?
10. Specific allocated portfolio
11. Attends staff meetings
*
Please Select
Yes
No
Sometimes
12. LaunchPad staff Values - Taking risks, Spirituality, Rituals, Straight-Talk.
15. Other
Tasks to be completed by specific dates/by next supervision session
Date for next Supervision session
-
Year
-
Month
Day
4 digit year, 2 digit month, 2 digit day
Date
Other Evidence for upload:
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