| Visit Date: May 16, 2020 | ID Number: 153130 | ||
| 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 | |||
| 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 | |||
| First Aid: Answered: Yes | |||
Child Development Concerns |
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| Early Intervention: Answered: Yes | |||
| Childcare Play and Learn and / or outdoor time. Answered: Yes | |||
| Referral to early intervention for a special needs child. Answered: Yes | |||
Health Related Social Needs Concerns |
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| Working with children with special healthcare needs. Answered: Yes | |||
| Hand-washing – diapering – toileting. Answered: Yes | |||
| Mental/Behavioral Health Services (Child). Answered: Yes | |||
HealthCare Concerns |
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| How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes | |||
| Child Caregiver relationship. Answered: Yes | |||
| Caregiver of Child relationship. Answered: Yes | |||
| Did you make a Community Resource-Referral. Answered: Yes | |||
| Resource-Referral Type(s). Food insecurity, Covid 19 Related Information |
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| Consultation Duration Start Time: 10:30 AM End Time: 11:00 AM Time Period: 30 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 the provider that I will come to the home and drop them a box of canned foods, and ather food stuffs..
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