PAT FORMS
Form used to prepare for personal visit?
Personal Visit Planning Guide
Form used to document resources?
Resource Connection Record
Form used to prepare for a Group Connection
Group Connection Planning Guide
Name a developmental screening used in PAT programs.
ASQs
How many Foundational Visits are there?
8
In the Model Implementation Workspace under which tab can parent educators access the commonly used PAT forms?
PAT Records
In the Resource Connection Record Instructions, it states that a resource connection should be updated at least _____________ .
Monthly
Which program form can participants complete that will help your PAT program build on its strengths and make plans to meet families’ needs in the future.
Group Connection Feedback Form
What is the name of the form that is used to document goals?
Goal Record
To count as a personal visit in the PAT model, what documents need to be completed?
Foundational Personal Visit Plan or Personal Visit Planning Guide and Personal Visit Record
Which form needs to be reviewed, discussed, and signed with the family by the end of the first Foundational visit relating to services and expectations of the PAT Program?
Participation Agreement and Consent for Services
Under what resource category is Food & Nutrition listed under?
Basic Essentials
Affiliates should have at least how many group connections through out the year to meet Essential Requirement #14.
12
This record lists skills and behaviors that children are developing.
PAT Milestone Record
Which form needs to be completed within 3 days of the completed personal visit form?
Personal Visit Record
What form is completed once the family is planning to exit the PAT Program?
Transition Plan or Family Service Record & Exit Summary
A new _________________ is started for each new resource connection provided to the family.
Resource Connection Record
A ___________ should be completed no more than three workdays after each group.
Group Connection Record
Which assessment(s) can a parent educator use to assist in creating a goal for the family?
LSP - Life Skills Progression
ASQ
What are the 3 Roles of a Parent Educator during a personal visit?
Reflecting, Partnering, Facilitating
The form that program participants can complete and will help us make our program the best it can be.
Parent Satisfaction Survey
Which form is completed when a Parent Educator would like to share that family's info with a resource agency?
Permission to Exchange Information
How many families need to attend a meeting/event to be counted as a group connection?
At least 1 enrolled or non-enrolled family.
Child health review is completed within ____ days of enrollment or the child’s birth
90
The Personal Visit Planning Guide consists of how many main sections?
5 (Opening, PCI, DCP, FWB, Closing)