| Visit Date: July 26, 2021 | ID Number: 153324 | ||
| Visit Count: | Children Served: Provider opted out of answer | Community Health Worker: Elsa O | |
Consultation services Delivered |
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| What type of Consultation was it? Phone or virtual consultation session | |||
| Consultation with providers/caregivers on administering ASQ * Answered: Yes | |||
Healthy and Safe Environment Concerns |
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| Is your home safe for children? : Answered: Yes | |||
| Safe Sleep: Answered: Yes | |||
| How to prevent the spread of illness: Answered: Yes | |||
| Being ready for a natural disaster: Answered: Yes | |||
Child Development Concerns |
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Health Related Social Needs Concerns |
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| Hand-washing – diapering – toileting. Answered: Yes | |||
HealthCare Concerns |
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| Taking care of yourself (Whole Person). Answered: Yes | |||
| Resource-Referral Type(s). Housing instability, Food insecurity, Covid 19 Related Information |
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| Consultation Duration Start Time: 7:35 PM End Time: 7:50 PM Time Period: 15 mins |
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Goals |
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| Progress Made Towards Goal?: | |||
| Goal Attained? | |||
| Progress made towards goal? | |||
Notes for this Consultation
I Called and informed the provider to renew fresh bucks at Lake City community
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