PAT FORMS
What form(s) is used to prepare for your personal visits?
Foundational Personal Visit Plans
Personal Visit Planning Guide
The assessment(s) that is used to assist in creating a goal for the family?
LSP - Life Skills Progression
ASQ
Form used or completed in VT to prepare for a Group Connection
Group Connection Planning Guide
The VT report monitors the ERs for FCA, Goals, Visit Frequency, Health Review, Developmental Screening, and Resources.
Performance Measures Report - PMR
True or False: Can personal visits take place if when the child has been removed by CPS from the home prior to or after enrollment in PAT?
True - When then the goal is reunification
In O.L.I.V.E.R. under which two WORKSPACES can parent educators access the commonly used forms?
Model Implementation-->PAT Records
Foundational -->Fillable Forms
In the Resource Connection Record Instructions, it states that a resource connection should be updated at least _____________ .
Monthly
What form is completed by participants that will help your PAT program when planning group connections in the future.
Group Connection Feedback Form
What can be used to help identify missing data in VT?
Data Quality Alerts
The forms used to prepare for a personal visit?
Foundational Personal Visit Plan
Personal Visit Planning Guide
A form that should 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
*Not required to use the PAT version, but must use a participation agreement and consent for services.
Under Essential Requirement #18, how many resource connections should families who received at least one visit during the program year have?
At least 1
How many group connections should be completed through out the year to meet ER #14.
How many families need to attend a meeting/event to be counted as a group connection?
12
1
Visit Frequency Report
Completed in Visit Tracker within 3 working days after your personal visit.
Personal Visit Record = PVR
Forms completed or printed once the family plans to exit the PAT Program? (Visit Tracker Reports)
1. Transition Plan (w/in 30 days)
2. Family Service Record & Exit Summary
(VT = Service Record & Child Exit Report)
This lists the skills and behaviors that children are developing.
PAT Milestones
*Affiliates can opt to use the CDC Milestones in place of the PAT Milestones.
What form do you complete in Visit Tracker that should be completed no more than three workdays after each group connection?
Group Connection Record
This report lists all your families assessments that have been completed and entered into Visit Tracker?
Assessment Report
The 3 Roles of a Parent Educator during a personal visit?
Reflecting, Partnering, Facilitating
The form that program participants can complete that will help your program improve.
Parent Satisfaction Survey
*Not required to use the PAT version; affiliates can use a different satisfaction survey.
Child health review is completed within ____ days of enrollment or the child’s birth?
90 days
Form available to new Parent Educators as a guide when creating a Group Connection?
Group Connection Preparation Checklist
The report monitors your program's data throughout the program year, to ensure your affiliate is on track to meet all Essential Requirements.
Affiliate Performance Report - APR
Report used to show details relating to the timely documentation of service delivery, including Personal Visit Planning Guides, Personal Visit Records, and Milestones Records.
Personal Visit Record (PVR) Report