DEPARTMENT OF REHABILITATION
PROGRAM TERMINATION
DR 229E (7/75)
CLIENT'S NAME (Last, first, middle initial)
CLIENT'S SOCIAL SECURITY NO. (000-00-0000)
Use this form to record the closure summary in all cases (08, 30, 28, 26) and the views of the client regarding any decision of ineligibility. Include here any plans for post-employment services.
January 18, 1976

Our current case file on Herbert Willsmore shows that he has been a client since 1968 at which time we began sponsorship at the University of California in the form of books, tuition, and Cowell Hospital residence. Secretarial and tutorial services were also provided. Transportation needwere met in terms of automobile repairs and provision of a suitably modified van. Academic work through the Master's Degree level was provided with appropriate support services.

Special tools such as typewriter, calculator and custom built desk were provided.

One attempt was made at an On-the-Job training project with the University of California at Berkeley although a full time job opportunity developed which Herb accepted and began on September 1, 1975. Herb has been performing satisfactorily in this capacity since that time.

Self Support Plan has been developed and approved for purchase of a home and modifications, replacement van and maintenance on present van. Herb's current earnings are $1,250.00 per month. As present, he retains full S.S.I., Medi-Cal, and attendant care benefits to assist in making a transition from being totally on S.S.I. to becoming totally independent. At the expiration of the Self Support Plan it is anticipated that these benefits will be substantially reduced and Herb will be primarily self supporting. Accordingly, it is felt appropriate at this time to close this case in Status "26" that of a successfully employed person.

Karen E. Topp
Rehabilitation Counselor
nab, 11/15/76
The above action represents the decision made after discussion with you. If you disagree with the action described above, please write your comments in the above space, or on the reverse side and return it to our office.
NOTICE TO CLIENT: If you are dissatisfied with the decision or action above, you have the right to ask for an administrative review by the Rehabilitation Supervisor.
CERTIFICATE OF INELIGIBILITY AND ANNUAL REVIEW
1. □ IT HAS BEEN DETERMINED THAT THE INDIVIDUAL NAMED ABOVE DOES NOT MEET THE CRITERIA OF ELIGIBILITY AT THIS TIME.
2. ANNUAL REVIEW IS REQUIRED □ YES □ NO
3. SHELTERED EMPLOYMENT CLOSURE (FOLLOW-UP REQUIRED) □ YES □ NO
REHABILITATION SUPERVISOR SIGNATURE DATE REHABILITATION SUPERVISOR SIGNATURE
DATE