| Visit Date: March 29, 2022 | 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 | |||
| Did you make a Child Development Referral (Not Screening) * Answered: Yes | |||
| 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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| Is your home safe for children? : Answered: Yes | |||
| Safe Sleep: Answered: Yes | |||
| How to prevent the spread of illness: Answered: Yes | |||
Child Development Concerns |
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| Childcare Play and Learn and / or outdoor time. Answered: Yes | |||
Health Related Social Needs Concerns |
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| Hand-washing – diapering – toileting. Answered: Yes | |||
HealthCare Concerns |
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| Child Caregiver relationship. Answered: Yes | |||
| Caregiver of Child relationship. Answered: Yes | |||
| Did you make a Community Resource-Referral. Answered: Yes | |||
| Resource-Referral Type(s). Covid 19 Related Information |
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| Consultation Duration Start Time: 4:50 PM End Time: 5:15 PM Time Period: 15 mins |
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Goals |
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| Progress Made Towards Goal?: No | |||
| Goal Attained? No | |||
| Goal attained | |||
Notes for this Consultation
I Called and gave card to the client.
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