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Visit Date: August 27, 2020 ID Number: 153135
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
Get information on how to help me cover my basic needs (food – clothing – housing – medical attention) Answered: Yes

Healthy and Safe Environment Concerns

Car Seat Safety: Answered: Yes
CPR: Answered: Yes

Child Development Concerns

Healthy Children

Hand-washing – diapering – toileting. Answered: Yes

Healthy Caregivers

How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes
Resource-Referral Type(s).
Food insecurity, Covid 19 Related Information
Consultation Duration

Start Time: 3:00 PM
End Time: 3:15 PM
Time Period: 15 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained?

Notes for this Consultation

I delivered to the provider gift Card, masks, Sanitizer, diapers and wipes.