HSF122520 Case 20 Note 20 Assessment 20 Activity 20 and 20 Script 20 For 20 Report 20420 Case 20 Notes 120
HSF122520 Case 20 Note 20 Assessment 20 Activity 20 and 20 Script 20 For 20 Report 20420 Case 20 Notes 120
Throughout this process the person acting as the shelter staff will be asked to conduct a
thorough assessment of the youth’s needs and summarize the interview in a case
note using the case note guidelines as presented in class. Week 4 Power Point.
Follow the guidelines below to ensure you have conducted a thorough intake interview.
Program Intake Assessment Work Sheet
1. Introduce yourself to the client and explain your role at the Agency
a. Child and Youth Worker
b. Supervisor
c. Recreation coordinator
d. Concurrent Disorders Counsellor
e. Part-Time Counsellor
f. Etc.
3. Ask the youth if they have any immediate needs. Ensure the following are
covered: (THIS MUST BE IN YOUR CASE NOTE)
a. Food
b. Medical
c. Shelter
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HSF 1225 Applied Human Services Practices – Case Note 31/01/2019
Questions to consider:
Are you hungry? Can I get you something to eat or drink?
______________________________________________________________________
How is your health? Do you have any immediate medical needs?
______________________________________________________________________
Can you please provide me with you name and DOB ? (It is important to collect a copy
of ID whenever possible and note that it was collected in your case note)
______________________________________________________________________
What has brought you to the Youth Centre today?
______________________________________________________________________
Where have you been staying prior to arrive here today?
______________________________________________________________________
How long have you been without shelter?
______________________________________________________________________
How have you been making ends meet to date?
______________________________________________________________________
Do you have any supports that we can assist you in contacting?
______________________________________________________________________
Do you have a vehicle?
______________________________________________________________________
What types of services have you been accessing in order to make ends meet?
______________________________________________________________________
Have you been using any alcohol or drugs in the past 72 hours?
______________________________________________________________________
In order for us to best support you we would like to ask you about any mental health or
addiction concerns you may have, is that ok with you?
______________________________________________________________________
Please tell me about any mental health concerns you are experiencing.
______________________________________________________________________
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HSF 1225 Applied Human Services Practices – Case Note 31/01/2019
Please tell me about any substance use concerns you have been experiencing.
______________________________________________________________________
Are you currently taking any medications? Do you have any medications with you? (It
would be important to document the medication the youth has and to inform them that
all medication must be kept locked in the staff office and administered by staff until
discharge)
______________________________________________________________________
After completing the interview, complete your case note and indicate what the result of
the intake interview was. Did the youth choose to be admitted? Did they choose to
leave? If they chose to leave, did they at least inform us of where they were going? If
they choose to stay, indicate this in the case note.
Marking Guidelines:
Complete = 1 Point
Detailed = 3 Points
Spelling and Grammar = 1 Point
Total Marks – 5
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