| Visit Date: March 6, 2020 | ID Number: 153160 | ||
| Visit Count: | Children Served: Provider opted out of answer | Community Health Worker: SIC Other Staff | |
Consultation services Delivered |
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| What type of Consultation was it? In-person 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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| How to prevent the spread of illness: Answered: Yes | |||
Child Development Concerns |
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| Early Intervention: Answered: Yes | |||
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 | |||
| Coping with stressful situations. Answered: Yes | |||
| Consultation Duration Start Time: 2:12 PM End Time: 2:32 PM Time Period: 15 mins |
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Goals |
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| Progress Made Towards Goal?: | |||
| Goal Attained? | |||
| Goal attained? | |||
Notes for this Consultation
Provider had called and requested diapers. Delivered diapers and had her sign last consent form for referral to Boyer for Part C evaluation. Her children are keeping her safe by keeping her from having to go out in public. They are all washing their hands and disinfecting the house frequently.
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