Resident Stage 4 Self Assessment

Resident Self-Assessment Questionnaire – Stage 4

Purpose: This self-assessment helps you reflect on your progress, personal growth, and relationships during this next stage of the program. It also allows you to take part in your care planning and encourages you to input into the decision-making process for our journey through the program.

SECTION 1 – REFLECTION AND INDEPENDENCE

1. How have you demonstrated consistent responsibility and reliability throughout this Stage of your program?(Required)

2. What areas of your life are starting to show long-term stability and self-management?(Required)

3. Do you manage your time, work, and commitments independently?(Required)

Explain(Required)

5. What personal habits or routines help you maintain structure and accountability?(Required)

SECTION 2 – LEADERSHIP, MENTORING, AND COMMUNITY INVOLVEMENT

Give Examples(Required)

3. Give examples of how you have shown initiative, teamwork, or problem-solving.(Required)

4. What responsibilities have you maintained without needing supervision?(Required)

5. How do you demonstrate servant leadership and contribute to a culture of respect and accountability?(Required)

SECTION 3 – RELATIONSHIPS, COMMUNICATION, AND BOUNDARIES

1. How do you maintain healthy communication and boundaries with peers, staff, and people outside the program?(Required)

2. How have your relationships changed as you are recovering and maturing?(Required)

4. How do you handle feedback and conflict with calmness and respect?(Required)

5. What values guide your interactions in and outside the program?(Required)

SECTION 4 – EMOTIONAL, SPIRITUAL, AND LIFESTYLE GROWTH

1. How have your emotional regulation and self-awareness improved in Stage 4?(Required)

2. What spiritual or personal growth practices do you now maintain independently?(Required)

3. How have honesty, gratitude, and humility shaped your approach to life and others?(Required)

4. How are you managing stress, work balance, and personal wellbeing?(Required)

5. How prepared do you feel for greater freedom and accountability in Stage 5?(Required)

SECTION 5 – TRANSITION AND FUTURE PLANNING

1. What are your goals for the next part of your program and for life beyond residential care?(Required)

2. How are you preparing for to create and participate in community service and serving in the community?(Required)

3. What financial, relational, or lifestyle skills are you using consistently?(Required)

4. What supports or mentors will help you maintain recovery and accountability after graduation?(Required)

5. Is there anything you would like to share about your journey, Spiritual awareness, or readiness to transition?(Required)

Date