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FFN Intake Listings

General Information

Visit Date: ID Number: 153105
Provider Community: Somali2 Community Health Worker:
Primary language: Somali Do you read write in this language: No
Other languages: Do you read write in this language:
Children in Care are: Family Provider Relationship:
Number of Children: 5 Ages are: 3yrs, 6yrs, 8yrs, 10yrs, 15yrs
Location where care takes place:

Healthy and Safe Envionments

  1. Is your home safe for all the children?
  2. Safe Sleep
  3. How to prevent the spread of illness
  4. First Aid/CPR/Being ready for a natural disaster
  5. Car Seat Safety