| Visit Date: March 20, 2020 | ID Number: 153242 | ||
| 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? 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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| Is your home safe for children? : Answered: Yes | |||
Child Development Concerns |
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| How do I incorporate activities from my homeland that will support the healthy development of my children?: 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). Housing instability |
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| Consultation Duration Start Time: 3:00 AM End Time: 3:45 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
Completed Social Determants of Health Screen ing.
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