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["訪問型職場適応援助者助成金"]
["支援対象障害者名簿（様式第９号）及び活動実績状況報告書（総括票）兼申請額計算書（様式第１０号）作成ツール"]
[]
[null,"１　入力方法"]
[null,"① 右の「入力フォームを開く」ボタンをクリックします。"]
[null,"② 入力フォーム画面から支援対象者情報、基本情報、活動内容を入力していきます。"]
[null,"③ 途中で保存する場合は、「保存」ボタンをクリックします。"]
[null,"④ 入力済の支援対象障害者の方はこのMainシートで確認できます。"]
[]
[null,"２　出力方法"]
[null,"① 入力フォーム画面の「様式第9号 / 第10号　出力」ボタンをクリックします。"]
[null,"② 様式第９号及び様式第10号がまとめて出力されます。"]
[]
[null,"３　その他"]
[null,"① 作成に当たっては記入上の注意を必ずご確認ください。",null,"→　記入上の注意"]
[null,"② ファイル名は必要に応じて変更いただいて差し支えありません。"]
[null,"③ 詳しい説明書は機構ホームページ（この申請様式作成フォームをダウンロードいただいたページ）からご覧いただけます。"]
[]
[null,"入力済のデータ","0 件","※行をダブルクリックで編集"]
[null,"支援対象障害者番号","支給対象期","氏名"]

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["等級",null,"支援等の内容","計画策定","フォローアップ日数入力",null,"フォローアップ日数",null,"元号"]
["ー"]
["1級",null,"支援計画策定","✓",null,null,1,null,"昭和"]
["2級",null,"支援",null,null,null,2,null,"平成"]
["3級",null,"ケース会議",null,null,null,3]
["4級",null,"フォローアップ",null,"✓"]
["5級"]
["6級"]
["重度"]
["重度以外"]

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[]
[null,"【記入上の注意】"]
[null,"・　本様式は、支給対象期内に訪問型職場適応援助者による支援の計画（以下「支援計画」という。）に沿って支援を行った支援対象労働者ごとに作成してください。なお、本様式は「訪問型職場適応援助者助成金支給申請書」の別紙となりますので、必ず添付してください。"]
[]
[null,"・　「支援対象障害者番号」欄には、今期に申請する支援対象障害者について、連番を付してください。今期の支給申請に係る書類で「支援対象障害者番号」を記入することとされているところには、その番号を記入してください。"]
[null,"・　支援対象障害者の「勤務形態」、「雇入（予定）日」欄、「就労継続支援A型事業の利用者への該当の有無」欄については、支給申請の都度、支給対象期中の変更の有無を支援対象障害者を雇用する事業主に確認して記入してください。"]
[null,"　　変更があったことを申請せずに助成金の受給を受けた場合は、返還等の対象となります。"]
[null,"・　「支援対象障害者雇用事業所」欄には、支援対象障害者を雇用する事業所に係る雇用保険適用事業所番号及び住所、電話番号、名称、代表者氏名を記入してください。"]
[null,"・　「勤務先事業所」欄については、支援対象障害者が勤務する事業所が「支援対象障害者雇用事業所」欄と異なる場合に記入してください。"]
[null,"・　「支援形態」欄は、該当する支援形態の番号に○を付けてください。４に○を付けた場合は、「別の支給申請に係る雇用保険適用事業所名」を記入し、別の支給申請に係る雇用保険事業所の職場適応援助者との同日の支援の有無について、「同日の支援」欄に○を付けてください。"]
[null,"　　ただし、「支援等の内容」欄の「支援計画策定」又は「ケース会議」に該当する支援については、訪問型職場適応援助者が行った支援について、２人まで助成対象となりますので、同日に行った支援が全て当該支援に該当する場合は、「同日の支援」欄は『なし』に○を付けてください。"]
[null,"　　なお、同日に行った支援が当該支援以外の場合、１日の助成金額を、支援を行った人数で除して支給するなどの調整を行います。"]
[null,"　　この場合、これらの助成金額の確認のため、助成金の支給が遅れる可能性があります。"]
[null,"　　また、「同日の支援」欄が『なし』になっていたにもかかわらず、後から同日の支援があったことが判明した場合、返還等の対象となります。"]
[]
[null,"・　「支援計画期間」欄には、添付する訪問型職場適応援助者支援計画書等の内容を転記してください。"]
[null,"・　「時間数」欄には、移動時間を含めた１日の支援時間を記載して下さい。"]
[null,"・　今期活動内容欄については、下記にご留意の上、「支援等の内容」欄のいずれかの項目を○で囲んでください。"]
[null,"・「支援計画策定」とは、法人が自ら「訪問型職場適応援助者支援計画書」又は「訪問型職場適応援助者総合記録票」を策定した場合のほか、　地域センターが作成する計画に関して訪問"]
[null,"　型職場適応援助者が計画策定に係る活動を実施する場合をいい、１人の対象障害者当たり以下の日数（４時間　未満の支援の場合は１／２日として取扱います）までとします。"]
[null,"　① 訪問型職場適応援助者が支援計画書を策定し、地域センターが承認する場合、４日（少なくとも１日は支援に係る事業所を訪問すること）"]
[null,"　② 訪問型職場適応援助者がフォローアップ計画書を策定し、地域センターが承認する場合、１日"]
[null,"　③ 地域センターが支援計画書を作成し、訪問型職場適応援助者が支援計画策定に係る活動を行う場合、２日"]
[null,"　　例：支援の実施に係る事業所の職場環境、本人の職務内容の把握又は従事予定の作業内容把握のための事業所訪問の実施"]
[null,"　　　　訪問型職場適応援助者支援計画書（案）の作成　など"]
[null,"・「支援」とは、（独）高齢・障害・求職者雇用支援機構が作成又は承認した「訪問型職場適応援助者支援計画書」に基づく支援対象障害者、支援対象事業主及び家族に対する支援をいい"]
[null,"　ます。"]
[null,"　　例：支援対象障害者に対する挨拶・返事、報告・質問、会話への参加等のコミュニケーション能力の向上に係る支援"]
[null,"　　　　事業主に対する障害特性の理解と障害に配慮した対応方法に係る助言・援助"]
[null,"　　　　家族に対する障害特性と家族の対応の在り方、関係機関の利用方法に係る助言・援助　など"]
[null,"・「ケース会議」とは、地域センターが開催するケース会議をいいます。"]
[null,"・「フォローアップ」とは、「訪問型職場適応援助者総合記録票」に基づき実施される支援をいいます。精神障害者に係る通常のフォローアップ期間"]
[null,"　経過後の追加のフォローアップ期間の支援は3回までです。"]
[null,"　これを実施した場合は、「支援等の内容」の「フォローアップ」の横のカッコの中に何回目の支援であるか記入してください。"]
[]
[null,"・　「訪問先等名称」欄には支援等の内容を実施するために訪問した場所を記載してください。"]
[]
[null,"・　支援計画の日数より支援実施日数が超過する場合、理由書の提出が必要となります。"]
[]
[null,"・　支援実施場所の如何を問わず、支援対象障害者が事務所を訪問したことに対応した等の計画によらない突発的な相談は、原則として助成金の対象となりませんのでご注意ください。"]
[null,"　　日程調整上の都合等の合理的な理由が認められる場合や支援対象事業主からの緊急の要請に対応した場合を除き、助成金が支給されなかったり、法人の受給資格認定が取り消される場合がありますので、ご注意ください。"]
[null,"　必要に応じて支援内容について、支援記録票による支援日誌の提出依頼や、支援対象事業主に対する聴取を行う場合があります。"]

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[null,"活動内容"]
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["援助者番号","援助者氏名"]

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[null,"（様式第９号（訪））\n（ 99 枚　/　全 99 枚）"]
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[]
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["①",null,null,"（ア）のうち、\n1日の支援時間の合計が４時間以上又は精神障害者の支援の合計が３時間以上の日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"日",null,null,"×",16000,null,null,null,null,null,"円","＝",{"$f":"V58*AG58","v":0},null,null,null,null,null,null,"円"]
[]
[]
["②",null,null,"（ア）のうち、\n1日の支援時間の合計が４時間未満の日（ただし、①に計上したものは除く）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"日",null,null,"×",8000,null,null,null,null,null,"円","＝",{"$f":"V61*AG61","v":0},null,null,null,null,null,null,"円"]
[]
[]
["支援等に係る助成額（①＋②）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"AO58+AO61","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
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["　",null,null,"【支給額】"]
[null,"障害の種別",null,null,null,null,null,null,null,null,null,null,"支援時間",null,null,null,null,null,null,null,null,"支給額（１日あたり）"]
[null,"精神障害者",null,null,null,null,null,null,null,null,null,null,"３時間以上",null,null,null,null,null,null,null,null,"16,000円"]
[null,null,null,null,null,null,null,null,null,null,null,null,"３時間未満",null,null,null,null,null,null,null,null,"8,000円"]
[null,"精神障害者以外",null,null,null,null,null,null,null,null,null,null,"４時間以上",null,null,null,null,null,null,null,null,"16,000円"]
[null,null,null,null,null,null,null,null,null,null,null,null,"４時間未満",null,null,null,null,null,null,null,null,"8,000円"]

{"sheet":"Template_Status","index":8,"n_rows":2,"n_cols":3,"rows_kept":2,"cut":false,"hidden":true,"merged":[]}
["支援実施状況"]
["職場適応援助者氏名","番号","支援等に関わる助成額"]

{"sheet":"Wk_Act","index":9,"n_rows":98,"n_cols":13,"rows_kept":98,"cut":false,"hidden":true,"merged":[]}
[1,"2022-09-01","01:00:00",1,"援助　太郎","支援対象者１","身体障害","その他",4.1666666666666664E-2]
[1,"2022-09-01","01:00:00",1,"援助　太郎","支援対象者１","身体障害","その他",4.1666666666666664E-2]
[2,"2022-09-01","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,2,1,3]
[2,"2022-09-04","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-07","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-10","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-13","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-16","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-19","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-22","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-25","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-28","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-01","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-04","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-07","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-10","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-13","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-16","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-19","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-22","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-25","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-28","01:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-31","02:00:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,8.3333333333333329E-2,0,2,2]
[1,"2022-12-31","02:30:00",1,"援助　太郎","支援対象者１","身体障害","その他",0.10416666666666667]
[3,"2022-12-31","01:30:00",1,"援助　太郎","支援対象者３","身体障害\r\n高次脳機能障害","その他",6.25E-2,null,4,0,4]
[2,"2023-01-01","01:31:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,6.3194444444444442E-2,0,1.5166666666666666,1.5166666666666666]
[2,"2023-01-04","01:34:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,6.5277777777777782E-2,0,1.5666666666666669,1.5666666666666669]
[2,"2023-01-07","01:37:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,6.7361111111111108E-2,0,1.6166666666666667,1.6166666666666667]
[2,"2023-01-10","01:40:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,6.9444444444444434E-2,0,1.6666666666666665,1.6666666666666665]
[2,"2023-01-13","01:43:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,7.1527777777777787E-2,0,1.7166666666666668,1.7166666666666668]
[2,"2023-01-16","01:46:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,7.3611111111111113E-2,0,1.7666666666666666,1.7666666666666666]
[2,"2023-01-19","01:49:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,7.5694444444444439E-2,0,1.8166666666666664,1.8166666666666664]
[2,"2023-01-22","01:52:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,7.7777777777777779E-2,0,1.8666666666666667,1.8666666666666667]
[2,"2023-01-25","01:55:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,7.9861111111111105E-2,0,1.9166666666666665,1.9166666666666665]
[2,"2023-01-28","01:58:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,8.1944444444444445E-2,0,1.9666666666666668,1.9666666666666668]
[2,"2023-01-31","02:01:00",1,"援助　太郎","支援対象者２","精神障害","精神",null,8.4027777777777771E-2,0,2.0166666666666666,2.0166666666666666]
[2,"2022-09-02","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-05","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-08","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-11","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-14","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-17","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-20","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-23","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-26","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-29","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-02","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-05","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-08","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-11","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-14","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-17","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-20","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-23","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-26","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-29","01:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-12-30","03:00:00",2,"援助　花子","支援対象者２","精神障害","精神",null,0.125,0,3,3]
[2,"2023-01-02","01:32:00",2,"援助　花子","支援対象者２","精神障害","精神",null,6.3888888888888884E-2,0,1.5333333333333332,1.5333333333333332]
[2,"2023-01-05","01:35:00",2,"援助　花子","支援対象者２","精神障害","精神",null,6.5972222222222224E-2,0,1.5833333333333335,1.5833333333333335]
[2,"2023-01-08","01:38:00",2,"援助　花子","支援対象者２","精神障害","精神",null,6.805555555555555E-2,0,1.6333333333333333,1.6333333333333333]
[2,"2023-01-11","01:41:00",2,"援助　花子","支援対象者２","精神障害","精神",null,7.013888888888889E-2,0,1.6833333333333333,1.6833333333333333]
[2,"2023-01-14","01:44:00",2,"援助　花子","支援対象者２","精神障害","精神",null,7.2222222222222229E-2,0,1.7333333333333334,1.7333333333333334]
[2,"2023-01-17","01:47:00",2,"援助　花子","支援対象者２","精神障害","精神",null,7.4305555555555555E-2,0,1.7833333333333332,1.7833333333333332]
[2,"2023-01-20","01:50:00",2,"援助　花子","支援対象者２","精神障害","精神",null,7.6388888888888895E-2,0,1.8333333333333335,1.8333333333333335]
[2,"2023-01-23","01:53:00",2,"援助　花子","支援対象者２","精神障害","精神",null,7.8472222222222221E-2,0,1.8833333333333333,1.8833333333333333]
[2,"2023-01-26","01:56:00",2,"援助　花子","支援対象者２","精神障害","精神",null,8.0555555555555561E-2,0,1.9333333333333336,1.9333333333333336]
[2,"2023-01-29","01:59:00",2,"援助　花子","支援対象者２","精神障害","精神",null,8.2638888888888887E-2,0,1.9833333333333334,1.9833333333333334]
[2,"2022-09-03","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-06","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-09","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-12","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-15","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-18","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-21","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-24","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-27","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-09-30","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-03","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-06","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-09","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-12","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-15","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-18","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-21","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-24","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-27","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-10-30","01:00:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,4.1666666666666664E-2,0,1,1]
[2,"2022-12-31","01:30:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,6.25E-2,0,1.5,1.5]
[2,"2023-01-03","01:33:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,6.458333333333334E-2,0,1.5500000000000003,1.5500000000000003]
[2,"2023-01-06","01:36:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,6.6666666666666666E-2,0,1.6,1.6]
[2,"2023-01-09","01:39:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,6.8749999999999992E-2,0,1.65,1.65]
[2,"2023-01-12","01:42:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,7.0833333333333331E-2,0,1.7,1.7]
[2,"2023-01-15","01:45:00",3,"援助　三郎","支援対象者２","精神障害","精神",null,7.2916666666666671E-2,0,1.75,1.75]
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[]
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