| Visit Date: September 26, 2021 | ID Number: 153164 | ||
| Visit Count: | Children Served: 1 | Community Health Worker: SIC Other Staff | |
Consultation services Delivered |
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| What type of Consultation was it? Phone or virtual consultation session | |||
| Get information on how to help me cover my basic needs (food – clothing – housing – medical attention) Answered: Yes | |||
Healthy and Safe Environment Concerns |
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| Safe Sleep: Answered: Yes | |||
Child Development Concerns |
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Health Related Social Needs Concerns |
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HealthCare Concerns |
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| How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes | |||
| Coping with stressful situations. Answered: Yes | |||
| Caregiver of Child relationship. Answered: Yes | |||
| Resource-Referral Type(s). Family and community support |
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| Consultation Duration Start Time: 12:00 AM End Time: 12:50 AM Time Period: 45 mins |
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Goals |
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| Progress Made Towards Goal?: | |||
| Goal Attained? | |||
| Progress made towards goal? | |||
Notes for this Consultation
Provider called. Stated her 12yr old sister told her last night that her 21 yr old brother made her suck his penis multiple times starting when she was 3yrs old and he was 12yr old. Consultation offered support Provider this morning in call to cps. Provider has child with her.
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