17 Guam Code Ann. § 41305
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(a) DSSID shall develop and administer an application and assessment system for persons with disabilities. If DSSID determines that the person is eligible for services under this Chapter within the limits of Federal or local resources available for the purposes of this Chapter, an individualized service plan for the person shall be prepared within thirty (30) days by an interdisciplinary team for the person and DCSID may provide case management services to the person. DSSID will provide for an annual review and update of plan.
(b) The procedure for assessment of the person and elements of the individualized service plan shall be as described in policies and procedures adopted by DSSID. The individualized service plan shall be in writing and shall include, at a minimum, the nature of the needs of the person, goals and specific services to be offered to the person to attain these goals.