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Visit Date: September 21, 2020 ID Number: 153134
Visit Count: Children Served: Provider opted out of answer Community Health Worker: SIC Other Staff

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

Is your home safe for children? : Answered: Yes
How to prevent the spread of illness: Answered: Yes

Child Development Concerns

Health Related Social Needs Concerns

Hand-washing – diapering – toileting. Answered: Yes

HealthCare Concerns

Taking care of yourself (Whole Person). Answered: Yes
How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes
Coping with stressful situations. Answered: Yes
Resource-Referral Type(s).
Covid 19 Related Information
Consultation Duration

Start Time: 10:59 AM
End Time: 11:37 AM
Time Period: 45 mins

Goals

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

Notes for this Consultation

Provider stressed about medical decision recommendations she has full knee replacement surgery in a couple of weeks and her and home not having a plan to prevent and mitigate covid-19 infection. We agree to continue our working with her to provide ppe and working on a in home care plan for when she leave the hospital and will need other people coming and going in her home.