General Information |
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Visit Date: November 30, 2022 | ID Number: |
Provider Community: African-American | Community Health Worker: SIC Other Staff |
Primary language: | Do you read write in this language: |
Other languages: | Do you read write in this language: |
Children in Care are: | Provider Relationship: |
Number of Children: | Ages are: |
Location where care takes place: | |
Healthy and Safe Envionments |