資料３－２
英語. Japanese Proficiency Complimentary Form（Japanese Proficiency in certainSituations）

In each scene, how proficient is your Japanese?
① Medical Visit:[Hearing］１．I can understand the doctor’s instructions
２．I can understand most of the doctor’s instructions
３ I can understand a little of the doctor’s orders (I can pick up singlewords)
４．I mostly cannot understand the doctor’s instructions［Speaking］１. I can explain the symptoms in detail
２．I can mostly explain the symptoms
３．I can only explain the symptoms using simple words
４．I am mostly not able to explain the symptoms［Reading］１．I can read the medical forms entirely
２．I can read most of the medical forms
３．I can read a little of the medical forms
４．I am not able to read most the medical forms［Writing］１．I am able to fill out the medical forms entirely
２．I can fill out most of the medical forms
３．I can fill out a small amount (name, address)
４．I am not able to fill out most of the medical forms※Additional complimentary questions② Paying utilities［Reading］１．I can read utility bills entirely
２．I can read most of the utility bills
３．I can read a small amount（amount due, due date etc.）
４．I am not able to read utility bills.

③
Shopping［Hearing］１．I understand what’s being said on the sales floor
２．I mostly understand what’s being said on the sales floor
３．I understand a little（simple words）
４．I am mostly not able to comprehend［Speaking］１．I can talk about items I’d like purchase
２．I can mostly speak on items I'd like to purchase
３．I can speak a little（simple words）
４．I mostly cannot comprehend［Reading］１．I can fully read the shop signage
２．I can mostly read shop signage
３．I can read a little（simple words）
４．I'm mostly not able to read the signage資料３－２
英語※Additional complimentary questions④ Riding the train or the bus［Hearing］１．I can fully understand announcements on buses and trains
２．I can mostly understand announcements on buses and trains
３．I can understand a little （simple words）
４．I mostly cannot understand［Speaking］１．I can fully explain where I'd like to go
２．I can mostly explain where is like to go
３．I can explain a little（simple words）
４．I am mostly not able to explain［Reading］１．I can fully read transit maps
２．I can mostly read transit maps
３．I can read a little（destinations）
４．I am mostly not able to read transit maps

⑤ Parenting※Additional complimentary questions［Hearing］１．I fully comprehend the services offered by healthcare centers
２．I mostly understand services offered by healthcare centers
３．I understand a little （simple words）
４．I mostly do not understand［Speaking］１．I can fully explain my child’s condition of health
２．I can mostly explain my child’s condition of health
３．I can explain a little（simple words）
４．I mostly do not understand［Reading］１．I can fully read physical exam reports
２．I can mostly read physical exam reports
３．I can read a little（I can understand a few words）
４．I mostly cannot read them
［Writing］１．I am able to apply for benefits at the healthcare center
２．I am mostly able to apply for benefits at the health care center
３．I am somewhat able to apply（name and address etc.）
４．I am mostly not able to fill out applications in Japanese⑥ At the Workplace［Hearing］１．I can fully comprehend instructions
２．I can mostly comprehend instructions
３．I can somewhat comprehend（simple words）
４．I am not able to understand［Speaking］１．I am fully able to report work of progress
２．I am mostly able to report work of progress
３．I'm somewhat able to report （simple words）
４．I'm mostly not able to report progress※Additional complimentary questions

資料３－２
英語[Reading] １．I can fully read work instructions
２．I can mostly read work instructions
３．I can somewhat read（simple words）
４．I mostly am not able to read work instructions［Writing］１．I am fully able to write work reports
２．I am mostly able to write work reports
３．I can somewhat write reports（simple words）
４．I am mostly not able to write reports⑦ Interacting with neighbors［Hearing］１．I can fully understand self-introductions
２．I mostly understand self-introductions
３．I somewhat understand（name etc.）
４．I mostly cannot understand［Speaking］１．I can give a detailed self-introduction
２．I can give a simple self-introduction
３．I can give my name and origin
４．I am not able to give a self-introduction⑧ Government/Administrative Procedures［Hearing］１．I can fully comprehend procedural content
２．I mostly understand procedural content
３．I somewhat understand procedural content
４．I am mostly not able to understand procedural content［Speaking］１．I can fully discuss important matters at the ward office
２．I can mostly discuss important matters at the ward office
３．I'm somewhat able to discuss (simple words)
４．I am not able to［Reading］１．I'm able to fully read letters from the ward office
２．I can mostly read letters from the ward office
３．I can somewhat read the letters（simple words）
４．I mostly cannot read them
[Writing] １．I can write in kanji on necessary paperwork for resident certification
２．I can write in hiragana on necessary paperwork for resident
certification
３．I can write my name and address in hiragana on necessary paperwork
４．I am not able to write kanji, hiragana or katakana資料３－２
英語⑨ Regional［Hearing］１．I fully comprehend neighborhood council gatherings
２．I can mostly understand neighborhood council gatherings
３．I can somewhat understand（simple words）
４．I mostly cannot understand［Speaking］１．I can fully express my opinion at neighborhood council meetings
２．I can mostly express my opinion at neighborhood council meetings
３．I can somewhat express my opinion（simple words）
４．I'm mostly not able to express my opinion［Reading］１．I can fully read the neighborhood circulars
２．I can mostly read the neighborhood circulars
３．I can somewhat read them (simple words)
４．I mostly cannot read them［Writing］１．I can write in kanji on participant forms for neighborhood council events
２．I can write hiragana on participant forms for neighborhood council events
３．I can write simple words on forms for neighborhood council events
４．I cannot write kanji, hiragana or katakana⑩ Post Office Procedures[Hearing] １．I fully understand the available services
２．I mostly understand the available services
３．I somewhat understand（simple words）
４．I mostly do not understand［Speaking］１．I can clearly state the services I want to use
２．I can mostly state the services I want to use
３．I can somewhat explain（through simple words）
４．I mostly cannot explain［Reading］１．I can fully read delivery notices
２．I can mostly read delivery notices
３．I can somewhat read them（contact info, next send date etc.）
４．I mostly cannot read delivery notices［Writing］１．I can fully fill out delivery vouchers in kanji
２．I can fill out delivery vouchers in hiragana
３．I can fill out my name and address in delivery vouchers
４．I cannot write kanji, hiragana or katakana