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Visit Date: June 5, 2020 ID Number: 153236
Visit Count: Children Served: Provider opted out of answer Community Health Worker: Elsa O

Consultation services Delivered

What type of Consultation was it? Phone or virtual consultation session

Healthy and Safe Environment Concerns

Is your home safe for children? : Answered: Yes
Safe Sleep: Answered: Yes

Child Development Concerns

Childcare Play and Learn and / or outdoor time. Answered: Yes

Health Related Social Needs Concerns

Hand-washing – diapering – toileting. Answered: Yes

HealthCare Concerns

Taking care of yourself (Whole Person). 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).
Covid 19 Related Information
Consultation Duration

Start Time: 5:20 PM
End Time: 5:40 PM
Time Period: 15 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Progress made towards goal?

Notes for this Consultation

I called the provider that how they are doing on this unprecedented and Challenging days l remind them that they have to be Wash their hands frequently and keep their distance and cover their faces by masks when ever they go to apublic