General Information
Visit Date: December 31, 2021	ID Number: 153136
Provider Community: African-American	Community Health Worker: SIC Other Staff
Primary language: English	Do you read write in this language:
Other languages:	Do you read write in this language: Yes
Children in Care are: Family	Provider Relationship:
Number of Children: 5	Ages are: 4yrs, 9yrs, 14yrs, 16yrs
Location where care takes place:
Healthy and Safe Envionments