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ACTIVITY WORKBOOKfor Home Visitor
Florida Maternal, Infant & Early Childhood Home Visiting Initiative
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Activity Check SheetCheck the checkbox next to the activity when completed.
ACTIVITY TITLE DURATION LOCATION
Getting Started
Home Visitor / Parent Educator Pre-self Assessment 30 min Online
Module 1 - Principles of Home Visitation
What is Home Visitation? 14 min 16 sec Online
• Like/Different Exercise 30 min Activity Workbook
Roles of a Home Visitor - Part 1 12 min 55 sec Online
• My Confidentiality Policy 30 min Activity Workbook
Roles of a Home Visitor - Part 2 18 min 57 sec Online
• Difficult Personalities and Situations 30 min Activity Workbook
• Coping Scenario 30 min Activity Workbook
25 Pitfalls of Home Visiting 2 min 15 sec Online
Is this a Problem? 39 min Online
Child Development Resources 2 min Online
Module 1: Test Your Knowledge Quiz 30 min Online
Module 1 Certificate 2 min Online
Module 2 - Family Systems
Family Systems 21 min 8 sec Online
Video: A child with special needs 27 min Online
Involvement of Fathers and Extended Family 10 min 28 sec Online
Complicating Factors in Family Development - Part 1 18 min 42 sec Online
Complicating Factors in Family Development - Part 2 8 min 15 sec Online
Complicating Factors in Family Development - Part 3 14 min 22 sec Online
Module 2: Test Your Knowledge Quiz 30 min Online
Module 2 Certificate 2 min Online
After Modules 1 and 2
Self-Reflection 1 30 min Activity Workbook
Module 4 - Communication
Communication 29 min 45 sec Online
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ACTIVITY TITLE DURATION LOCATION
• Paraphrasing Exercise 30 min Activity Workbook
• Type of Questions/Questioning Situations 30 min Activity Workbook
• “I” Messages 30 min Online
Problem Solving Process 8 min 49 sec Online
• Problem Solving Process #1 30 min Activity Workbook
• Problem Solving Process #2 30 min Activity Workbook
Coaching 17 min 39 sec Online
• Coaching or Confrontation? 30 min Activity Workbook
Home Visiting Scenario - Clarissa and Julie 45 min Online
Developing a Family Plan 23 min 29 sec Online
• Family Development Plan 15 min Activity Workbook
• Situation 1 Suggested Actions 15 min Activity Workbook
• Visioning & Goal Setting 30 min Activity Workbook
• Home Visitation Scenario 45 min Activity Workbook
Rescuing Checklist 30 min Online
Module 4: Test Your Knowledge Quiz 30 min Online
Module 4 Certificate 2 min Online
Module 5 - Observation and Documentation
Observation and Documentation 8 min 15 sec Online
Objectivity vs. Subjectivity 15 min Online
Module 5: Test Your Knowledge Quiz 15 min Online
Module 5 Certificate 2 min Online
After Modules 3, 4, and 5
Self-Reflection 2 20 min Activity Workbook
Home Visit Evaluation 1 hour 30 min Activity Workbook
Home Visit Narrative 15 min Activity Workbook
* IFSP (for EDN Services Coordinator Only) 30 min Activity Workbook
Module 6 - The Family Viewed in the Context of the Community
Family in the Community 22 min 56 sec Online
• Do you know about the community resources & services available? 30 min Activity Workbook
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ACTIVITY TITLE DURATION LOCATION
• Questions to ask yourself around community resources and services 5 min Activity Workbook
• Formalizing a Referral 30 min Activity Workbook
Module 6: Test Your Knowledge Quiz 20 min Online
Module 6 Certificate 2 min Online
Module 7 - Care of Self & Worker Safety
Managing Your Stress 23 min 15 sec Online
• How Do I Create My Own Stress? 30 min Activity Workbook
• Recurring sources of stress 30 min Activity Workbook
• Things I Can/Can’t Control 30 min Activity Workbook
Worker Safety Scenarios 40 min Online
Worker Safety Documents 10 min Online
Module 7: Test Your Knowledge Quiz 20 min Online
Module 7 Certificate 2 min Online
After Modules 6 and 7
Self-Reflection 3 20 min Activity Workbook
Home Visit Evaluation 1 hour 30 min Activity Workbook
Community Agencies 50 min Activity Workbook
Test Your Knowledge
Final Knowledge Test & Course Certificate 40 min Online
Home Visitor/Parent Educator Post Self-Assessment 20 min Online
TOTAL TIME 26 hours 53 min 26 sec
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WHAT IS HOME VISITATIONMODULE 1
The Home Visitor is a very unique role. Although it has many similarities to other roles, such as teachers, nurses and social workers, it is also quite different in many important ways.
Identify ways in which Home Visitation is LIKE and DIFFERENT from the roles listed below.
Like/Different Exercise
Like Different
Teaching
Social Worker/Family Therapist
Nurse
Friend
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ROLES OF THE HOME VISITOR - PART 1MODULE 1
Most agencies have confidentiality policies. Write them down and discuss with your supervisor.
My Agency’s Confidentiality Policy
Think about your own personal confidentiality policy, including how and with whom you will get support for your work with the family.
Write them down and discuss with your supervisor.
My Confidentiality Policy
In order to maintain the trust of families and to do my work as well as possible, I will ...
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ROLES OF THE HOME VISITOR - PART 2MODULE 1
What kinds of situations and personalities are the most difficult for you to handle?
Write them down in the table below and discuss with your supervisor. Ask your supervisor for assistance to develop ways to manage difficult situations.
Difficult Personalities and Situations
Difficult Personalities Difficult Situations How will I manage?
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ROLES OF THE HOME VISITOR - PART 2MODULE 1
This is your third visit to the Olson family. Mom and Dad are struggling with the adjustment to a new baby—a two month-old who has numerous medical problems due to a difficult birth. The baby has been diagnosed with cerebral palsy. It is unknown at this time if there will be cognitive delay.
During both of your previous visits, Mom has cried and Dad has been very quiet and non-participatory. During this visit, Mom shares that she doesn’t know how they will ever be able to parent their son, “in the way he should be taken care of.”
What are some possible coping issues this family could be dealing with?
Coping Scenario
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MODULE 1 & 2
End of Month OneAfter completing Modules 1 &2, reflect on what you have learned.
Self Reflection 1
Areas to reflect on:
1. My role as a home visitor and how others perceive me.2. My personal guidelines for doing my best work and how not to get into any pitfalls of home visiting.3. My need to be aware of all the aspects of a family and how it works.4. Awareness of a family’s way of coping.5. Awareness of a family’s way of dealing with the greater world.6. How can I become more aware of my own behavior so that families feel I am there to partner with them?
Ideas and information I don’t want to forget.
Things that would help me develop my skills.
Who and what can help me accomplish these?
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When I observe a mother using sarcastic language with her toddler, I just cringe. It is so confusing for kids.
When I feel misunderstood and criticized by a family member I am working with, I sometimes get defensive. I feel like I’m doing my very best to help them.
When there has been no follow-through on the mutually developed family plan since my last visit, I feel discouraged and disappointed in the family.
When I arrive at a home for a scheduled visit and no one answers the door, I find myself getting angry. This is such a waste of my time and money.
COMMUNICATIONMODULE4
Paraphrasing ExercisePlease paraphrase the following statements.
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Mother is usually only able to focus on things which are NOT going well.
It has been very difficult to get the family to be specific about their concerns about their child.
Your sense the parent is stressed but you are unsure about the causes of the stress.
Mother has difficulty thinking about any options to her problem situations.
COMMUNICATIONMODULE4
Types of Questions/Questioning SituationsRead the following situations and decide the most effective way to pose a questions.
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Read the following scenario and complete the problem solving form below based on this scenario.
Both parents are struggling with the many unexpected needs and complications around the baby. The parents share that money is very tight and they worry that if Mom is unable to return to work, they will be unable to keep the two older children in college. The insurance that currently covers the family is through the mom’s job. Both parents agree that Mom is better suited to stay home; but feel near panic about the expenses and other family needs including emotional needs of the four older children.
PROBLEM SOLVING PROCESSMODULE4
Problem Solving Process #1
The Issue ActionsDesired Outcome Big Picture ViewPersons Involved
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Read the following scenario and complete the problem solving form below based on this scenario.
You are working with a teenage mother who has just delivered a baby with cerebral palsy after a very difficult birth. She is living with her parents, both of whom work and are gone all day. The father of the baby is not involved at this time. The baby is having difficulty taking a bottle and cries a great deal. Mom tells you that her parents, the grandparents, are very angry at her getting pregnant and have expressed that she lives with them, but she has to take care of the baby on her own. She appears overwhelmed and possibly depressed.
PROBLEM SOLVING PROCESSMODULE4
Problem Solving Process #2
The Issue ActionsDesired Outcome Big Picture ViewPersons Involved
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COACHINGMODULE4
Coaching or Confrontation?Read each of the situations below. Does each of this situation calls for coaching or confrontation?
Circle your answer.
A mother with whom you work with has not been home for the past three scheduled appointments with you. Coaching Confrontation
A father with whom you work with as a home visitor puts his hand on your knee and says he’d like to spend more time with you. Coaching Confrontation
A home visitor you supervise shares frustration about a client not following through on the plan they have developed together. Coaching Confrontation
A home visitor you supervise tells a racially offensive joke in the office. Coaching Confrontation
As a home visitor, you watch a mother offer her toddler several choices for almost everything they are doing together. Coaching Confrontation
You overhear a home visitor you supervise sharing information about a client with the program secretary. Coaching Confrontation
During a home visit with a mom and grandmother, you notice that the grandmother does all the talking; never giving the mother a chance to respond to any questions you pose.
Coaching Confrontation
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Based on the scenario you have just read about Clarissa with the home visitor, Julie, write down the actions that Clarissa and Julie have identified below.
HOME VISITING SCENARIOMODULE4
Home Visiting Scenario - Clarissa and Julie
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Read the following scenario. What kinds of issues will be teased out as you work with this mom about pursuing this course? Complete the steps leading to this goal section below after you read this scenario.
Mrs. Williams, a teenage mother, wants to get a job so she can support herself and her two-year-old daughter. When she applied at a fast food restaurant, the manager said he would hire her part-time at minimum wage. If she wanted health insurance, she’d have to have it deducted from her paycheck.
She did some figuring and quickly realized she wouldn’t earn enough to pay the rent and other expenses, no matter how thrifty she was. But, she tells you that before she dropped out of school when her baby was born, she was enrolled in a computer course which she enjoyed. She thinks she could make better money if she finished this course.
DEVELOPING A FAMILY PLANMODULE4
Family Development Plan
A single teenage mom wants a job.
Major Goal:
Steps Leading to this Goal:
Family member(s) will do what by when
1.
2.
3.
1.
2.
3.
Worker will do what by when
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Identify the goals and then further identify the steps that the family members and family workers will take.
Family is being evicted from apartment next week because of structural problems caused by recent flooding. They are not on public assistance but have little resources and no savings.
Situation 1 Suggested Actions
DEVELOPING A FAMILY PLANMODULE4
Major Goal:
Steps Leading to this Goal:
Family member(s) will do what by when
1.
2.
3.
1.
2.
3.
Worker will do what by when
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How would you respond to each of the following situations? Practice identifying the words you would use with the families.
1. A mom you are working with explains that her goal for her son is for him to “behave like I want him to.”
DEVELOPING A FAMILY PLANMODULE4
Visioning & Goal Setting
2. You are working with the mom and the grandmother of a 4-month-old. The mom shares that she thinks her son sometimes cries just to make her mad. The grandmother supports this opinion and explains that the daughter used to do the same thing to her. Both women want to get a goal on the family plan that will address how to handle the crying.
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DEVELOPING A FAMILY PLANMODULE4
3. As you work with a young mom and dad during a home visit about goals and ways to assure support for the family, the father says, “I want to make a lot of money; that’s my goal. Then everything else will just take care of itself.”
4. A father explains to you that it is important to him that his three-year-old son is happy. His son has motor limitations and some cognitive delays. Numerous activities and goals have been identified to address these developmental areas and the family has worked on them with the teacher. He says to you, “I want it to be a goal that my son is happy, can we put that on our plan?”
5. A mother you are working with who is a single parent of two children under the age of five, shares with you that she has been diagnosed with Multiple Sclerosis. She is very worried about her continued ability to care for her children and what the long term picture will be for the family.
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Answer the following questions based on the following phases of an interview scenario below.
As a home visitor, you are working with a young family: mother, 17 years of age, father, 17 years and a new baby who is 3 months old. The family is living in a small apartment. The grandparents on the mom’s side of the family are helping with the rent and have helped the couple get things set up. The father is working two jobs; both of which are part time and unskilled. The mom is staying home with the baby. You have worked with the couple during the pregnancy and through the birth of the baby. They have expressed commitment and love for each other and for making a good home for the baby. With the financial stress and the care of the baby, both parents are beginning to express their frustration. They have asked you to help them figure out some ways to get ahead and to do it in a way that everyone’s needs are met. You know this will be the focus of your next visit.
DEVELOPING A FAMILY PLANMODULE4
Home Visitation Scenario
1. How will you prepare for the visit?
2. What resources will you explore ahead of time and come prepared to discuss?
3. How will you set the agenda for the meeting with the parents?
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DEVELOPING A FAMILY PLANMODULE4
4. How will you approach goal-setting with them?
5. What will you plan to do to close the session and assure that everyone will take on a part of a plan?
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MODULE 3,4 & 5
End of Months Two and ThreeAfter completing Modules 3, 4 & 5, you must complete the following activities:
1. Self Reflection 2
Areas to reflect on:
1. Explore ways in which culture is put into action, and how culture affects human relations and specific issues related to culture which need to be honored.
2. My personal guidelines to be comfortable and willing to explore issues of racism and diversity.3. My need to be aware of honoring and maintaining boundaries when working with families.4. Awareness of a family’s confidentiality.5. How I can become more of a coach with families.6. Awareness of being respectful when observing and documenting.
Ideas and information I don’t want to forget.
Things that would help me develop my skills.
Who and what can help me accomplish these?
2. Home Visit Evaluation The purpose of this exercise is for the Supervisor to review the skill level and give constructive feedback to the process and skills of the home visitor. The Home Visit can be recorded or there could be a co-visit with the supervisor. The Evaluation Form is located in the Appendix of this Activity Workbook. The Evaluation Form will be completed by the Supervisor. Supervisor: You will need to print the Evaluation Form.
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3. Home Visit Narrative Complete a narrative as a result of the home visit exercise. The Supervisor will review the narrative to ensure it contains all required components and is non-judgmental and free from bias, etc.
4. *IFSP - For EDN Services Coordinator Only Services Coordinator will develop and review an IFSP with the Supervisor to ensure quality and required components.
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Law enforcement officials
City planning departments
Regional planning agencies
City recreation services
Neighborhood organizations
Middle schools and high school student leaders
Childbirth education
Domestic Violence Shelters
School counselors and faculty (family living, home economics)
Social services(including child protections, foster care, child care licensing specialist)
Men’s and women’s clubs, Service organizations(Kiwanis, Lions, Junior League, Optimists, Rotary, Assistance League, Jaycees, etc.)
Title I programs
State senators
Mayor
Community development communities
Girl and Boy Scouts
Head start
Early head start
Even start
Child guidance clinics
Mental health clinics
Counseling agencies
Human services organizations
Libraries
Teenage Parent Programs
Public Health
Community Resources & Services
City council members
Special education services providers
Early intervention planning region team
County commissioners
FAMILY VIEW IN THE CONTEXT OF THE COMMUNITYMODULE 6
The following are listing of many community resources that are available. This have all been generated and have come from home visitors. They have identified this as resources they have used for various things in their community and things and needs that their families have had and that their programs have had.
Go through this list. Check the check box next to the community resource you are not familiar with, you would like more information about, or you know but wonder how to use that with the family. Add any community resources or services that you know of.
It is important as a home visitor that you are familiar with all the possible resources that may be available to your family.
This is something that you should share with your supervisor and talk with her about. Learning about those, identifying what they are and what services they provide are something that your supervisor can help you with.
Do you know about the community resources & services available?
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FAMILY VIEW IN THE CONTEXT OF THE COMMUNITYMODULE 6
Family Planning AgenciesCamp Fire
La Leche League
Lamaze
PRIDE and other parent groups
MADD groups
Association for Retarded Citizens (ARC)
Teen Counseling Services
Vocational-technical programs and schools
Association of Retired Persons (AARP)
Colleges and universities
County extension service(including 4-H groups)
Job training
Marriage encounter/couple communication groups
Adoptive parents groups
Medical and immunization clinics
Food cooperatives
PTA and PTSA
United Way
Hospitals
Realtors
YMCA and YWCA
Red Cross
Council on Alcoholism
Alcoholics Anonymous, ALANON
Chemical dependency programs
Women’s Resources Centers
Early childhood care and education programs
Senior citizens groups and the American Legion
Ministerial associations, local churches, synagogues
WIC clinics
Pregnancy counseling services
Community leaders and opinion makers
Video stores
Publix housing officials
Business organizations
Media (newspaper, TV, radio)
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FAMILY VIEW IN THE CONTEXT OF THE COMMUNITYMODULE 6
Answer the following questions and discuss with your supervisor.
Questions to ask yourself around community resources and services
1. What do I know about the resources in my community?
2. What do I know about supporting parents?
3. What do I know about counseling that would be helpful to them?
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5. Are there some providers of resources out there that I know I will be using over and over again as I work with families and that I should go and meet them personally to introduce myself?
FAMILY VIEW IN THE CONTEXT OF THE COMMUNITYMODULE 6
4. Who can I look to for some of these resources?
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FAMILY VIEW IN THE CONTEXT OF THE COMMUNITYMODULE 6
Formalizing ReferralsListen to the example of formalizing a referral about Chappas family.
Write down all the critical skills that you can identify used by the home visitor, Winona Roberts.
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CARE OF SELF & WORKER SAFETYMODULE 7
How do I create my own stress?Think back over the past two weeks. What are some ways in which you created pressure or anxiety for yourself?
Write them down.
And then look at your written list and see which of those were your reaction to things about what was happening outside of yourself and which were you reaction to beliefs about yourself and your own performance that you carried internally.
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CARE OF SELF & WORKER SAFETYMODULE 7
Recurring sources of stressIdentify some recurring sources of stress and write them down. You may want think about your work life and personal life.
Identify whether there are some old behaviors (behaviors you have used in the past and have worked for you) that you use in response to these stress triggers. Are these old behaviors still working for you effectively?
Are there some new behaviors/actions which you would like to express if a similar event occurred?
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CARE OF SELF & WORKER SAFETYMODULE 7
Things I can/can’t controlAs you prepare to nurture and support parents with whom you work, it is important to keep in mind what things you can and cannot control.
1. What things can you NOT control?
2. What things can you control?
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SCENARIOSMODULE 7
Worker Safety ScenariosAnswer the following questions based on each scenario.
Scenario 1
Services Coordinator (SC) Steve Winslow has been assigned to work with the Reznicek family. Kaylee Reznicek, who is two-years old, has been diagnosed with Primordial Dwarfism. Dawn Reznicek, the biological mother, called Steve requesting to meet with him today. Dawn stated that Kaylee has been “acting out” behaviorally, and she just can’t take much more of it. Dawn said sometimes she just feels like “giving up”. Steve made an appointment to meet with Dawn at 2:00 p.m.
Steve arrived as scheduled and spoke with Dawn. At approximately 2:15 p.m. the biological father, Kenneth, arrived at the home. He was angry about Steve being in the home and told Steve that he’s in the home to “take notes about getting their daughter taken away”. Steve left the home approximately five minutes later as Kenneth would not calm down.
Later that afternoon, Dawn called Steve to say that she wanted to talk. She wanted to meet at the family home at 9:00 A.M. the next morning, after Mr. Reznicek went to work. Shortly after Steve arrived at the home as scheduled, Mr. Reznicek walked in the front door. He was angry and accused Steve of coming over to “screw his wife.”
1. What are the worker safety issues in this situation?
2. How should Steve respond to this situation?
3. What, if anything, could have been done to prevent the worker safety threats in this situation?
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SCENARIOSMODULE 7
Scenario 2
Services Coordinator (SC) Nancy Lawrence lives in Omaha. To get to her house, Nancy needs to navigate through an extensive neighborhood on streets with several curves, dead ends, and cul-de-sacs. Nancy’s home is located on a cul-de-sac. One evening on her way home from work, Nancy notices another vehicle that appears to be following her through her neighborhood.
1. What are the worker safety issues in this situation?
2. How should Nancy respond to this situation?
Scenario 3
Services Coordinator (SC) Chaza Baraki has been assigned to assist Mr. Randy Morfield and his one-year old son Jake. Randy also has a seven-year old daughter who lives with her biological mother.
When Chaza arrived at the home, she observed black bags taped to the windows of the house. As she walked up to the house, she also observed numerous propane tanks and bottles with tubing in them.
1. What are the worker safety issues in this situation?
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Scenario 4
Services Coordinator (SC) Vicki Cohagen arrived for her scheduled home visit with the Nelson family. This is her first time meeting with the family at their home. As Vicki is about to exit her vehicle, she stops for a minute to take note of any signs of animals.
1. What signs should Vicki look for that would indicate the presence of animals? How should Nancy respond to this situation?
2. If there are animals that present a safety threat, how should Vicki respond?
SCENARIOSMODULE 7
2. What, if anything, could have been done to prevent the worker safety threats in this situation?
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SCENARIOSMODULE 7
Scenario 5
Services Coordinator (SC) Jennifer Bradley is visiting with Shawn Miller, who is the biological father of two-year old Kelsey. During the conversation, Shawn stated to Jennifer, “It’s very hard to father alone and I’ve been looking for a girlfriend for a long time.” Shawn then states, “I haven’t been laid in two years.”
1. What are the worker safety issues in this situation?
2. How should Jennifer respond to this situation?
3. What, if anything, could have been done to prevent the worker safety threats in this situation?
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Scenario 6
Services Coordinator (SC) Jill McMillan, age 21, has been assigned to work with Angel Ferguson and her two-year old son Dustin. Dustin has been identified as being developmentally delayed, and Dustin has difficulty standing. He is currently undergoing medical testing to identify the underlying cause of his physical disabilities.
Angel and Dustin live with Edward Pashinko, who is Angel’s biological father. Edward is currently on parole. He was convicted of sexually molesting Angel and her cousin when they were ten years old. Edward was released from the Pelican Bay State Prison in California earlier this year.
1. What are the worker safety issues in this situation?
2. How should Jill respond to this situation?
SCENARIOSMODULE 7
3. What, if anything, could have been done to prevent the worker safety threats in this situation?
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MODULE 6 & 7
End of Months Four, Five, and SixAfter completing Modules 6 & 7, you must complete the following activities:
1. Self Reflection 3
Areas to reflect on:
1. My personal guidelines that put into practice collaborative strategies for working with various service programs2. My personal guidelines for effective ways to advocate for families within a community while maintaining ongoing,
positive relationships with program providers.3. My needs to identify a process for helping families build support networks for themselves.4. My personal guidelines to assure personal safety when working in the community and home settings.
Ideas and information I don’t want to forget.
Things that would help me develop my skills.
Who and what can help me accomplish these?
2. Home Visit Evaluation The purpose of this exercise is for the Supervisor to review the skill level and give constructive feedback to the process and skills of the home visitor. The Home Visit can be recorded or there could be a co-visit with the supervisor. The Evaluation Form is located in the Appendix of this Activity Workbook. The Evaluation Form will be completed by the Supervisor. Supervisor: You will need to print the Evaluation Form.
3. Community Agencies Introduce yourself to at least 5 community agencies.
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APPENDIX
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Sample Information Card
Type of service:
Contact Person:
Agency, school, or business name:
How is the person eligible?
Days, hours of operation:
Notes:
40Adapted from UNL-CCFL Field Evaluation
The purpose of this exercise is for the Supervisor to review the skill level and give constructive feedback to the process and skills of the home visitor. The Home Visit can be recorded or there could be a co-visit with the supervisor.
Home Visitor:
Supervisor:
Date:
Family (Last Name):
Home Visit Evaluation Form
PREPARATION
LINKAGES
1. Knew essential background or current information about family prior to meeting (e.g. names, ages, worker safety, services, resources, etc.)
Not at all (0)
Somewhat (1)
Very Much (2)
Did not introduce (0)
Shared name but not role (1)
Shared both name and role (2)
2. Had a clear plan or agenda plan prior to meeting; could clearly describe purpose of meeting
Never/Rarely (0)
Sometimes (1)
Frequently / Always (2)
Never/Rarely (0)
Sometimes (1)
Frequently / Always (2)
No clear plan or agenda; could not describe purpose of visit (0)
Somewhat clear plan or agenda; described purpose in general or vague teams (1)
Clear plan or agenda; could clearly describe purpose of meeting (2)
Not applicable (Home Visitor met family previously)
Did not introduce self (0)
Shared name but not role (1)
Shared both name and role (2)
3. Introduced self
4. Introduced Supervisor / co visitor
5. Asked questions and checked for understanding (open questions, clarifications, paraphrases)
6. Exhibited attending skills (head nods, eye contact, engaged posture, nonjudgmental and interested facial expressions mirroring of tone and pace, pauses after questions).
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Did not seek involvement from everyone; focused primarily on input from one person or a few people (0)
Sought involvement and participation from most people (1)
Sought involvement from everyone (2)
Adapted from UNL-CCFL Field Evaluation
PREPARATION
None (0)
Some (1)
All (2)
Never/Rarely (0)
Sometimes (1)
Frequently / Always (2)
Never/Rarely (0)
Sometimes (1)
Frequently / Always (2)
Not at all (0)
Briefly or incompletely (1)
Throughly (2)
Not at all (0)
Briefly or incompletely (1)
Throughly (2)
Not applicable
No (0)
Yes (2)
Not applicable
Not at all (0)
Briefly or incompletely (1)
Thoroughly (2)
7. Respond to questions, provided or attempted to provide a response without reliance on the supervisor, offered to get answers and follow-up)
8. Reviewed agenda or purpose of meeting with the family.
9. Encouraged involvement and participation of all individuals
10. Kept meeting focused
11. Addressed agenda items
12. Summarized issues discussed
13. Outlined expectations and tasks (what needs to be done by whom and by when)
14. Confirmed agreement or understanding with/among family
42Adapted from UNL-CCFL Field Evaluation
PAPERWORK
Not applicable
Not at all (0)
Briefly or incompletely (1)
Thoroughly (2)
15. Scheduled next meeting Not applicable
Did not schedule next meeting (0)
Scheduled meeting without accommodating family’s needs (e.g. time, place)(1)
Scheduled meeting that would best fit family’s needs (e.g. time, place) (2)
Not applicable
Not at all (0)
Briefly or incompletely (1)
Thoroughly (2)
Not applicable
None (0)
Some (1)
All (2)
Not applicable
None (0)
Some (1)
All (2)
Not applicable
No (0)
Yes (2)
16. Discussed what would be addressed at the next meeting
17. Document next meeting time for family or committed to sending a notice at a later time
18. Prepared necessary paperwork prior to meeting
19. Completed/finalized necessary paperwork during meeting
20. Explained or discussed paperwork with family
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Rarely / Never (0)
Sometime (1)
Frequently / Always (2)
Rarely / Never (0)
Sometime (1)
Always (2)
Adapted from UNL-CCFL Field Evaluation
CONFIDENCE
POLICY
WORKER SAFETY
FAMILY-CENTERED PRACTICE PRINCIPLES
STRENGTHS
21. Manner suggest confidence, certainty, and assuredness (vs. apprehension, uncertainty, or doubt)
22. Followed policy and protocol
23. Maintained personal safety by following safety guidelines
24. Demonstrated family centered practice principles: Compassion, Individualized, Family/Person Driven, Strength-Based, Culturally Competent, Team Developed and Supported, Outcome Focused, Needs Driven, Flexible
Rarely / Never (0)
Sometime (1)
Frequently / Always (2)
Not at all (0)
Somewhat (1)
Very Much (2)
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AREAS FOR IMPROVEMENT
OTHER
TOTAL POINTS EARNED: TOTAL POINTS POSSIBLE: FINAL SCORE:
Adapted from UNL-CCFL Field Evaluation