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Healthy Start/Family Spirit Reflective Supervision Report
1.
What site are you reporting from?
AIHFS
Bay Mills
Grand Traverse Bay Band
Nottawaseppi Huron Potawatomi
Little Traverse Bay Band
Saginaw Chippewa Indian Tribe
Hannahville
Keweenaw Bay
Sault Tribe
Lac Vieux Desert
Pokagon
Little River Band
2.
What MONTH are you reporting on for Reflective Supervision Sessions?
January
February
March
April
May
June
July
August
September
October
November
December
3.
What YEAR are you reporting on for Reflective Supervision Sessions?
2024
2025
2026
2027
2023
4.
Please list the home visitors who are eligible to complete home visits during this month (who have been trained to deliver the Family Spirit Model):
Home Visitor #1
Home Visitor #2
Home Visitor #3
Home Visitor #4
Home Visitor #5
Home Visitor #6
Home Visitor #7
5.
Please enter the following information around who completed individual and/or group reflective supervision sessions:
Attended Individual Reflective Supervision Session
Attended Group Reflective Supervision Session
If "NO" for either individual or group sessions please indicate why:
Home Visitor #1
-- Select an option --
Yes
No
No Individual Sessions held this month
-- Select an option --
Yes
No
No Group Sessions held this month
-- Select an option --
On leave
Did not have time to attend
OTHER
(Please detail in comments)
Home Visitor #2
-- Select an option --
Yes
No
No Individual Sessions held this month
-- Select an option --
Yes
No
No Group Sessions held this month
-- Select an option --
On leave
Did not have time to attend
OTHER
(Please detail in comments)
Home Visitor #3
-- Select an option --
Yes
No
No Individual Sessions held this month
-- Select an option --
Yes
No
No Group Sessions held this month
-- Select an option --
On leave
Did not have time to attend
OTHER
(Please detail in comments)
Home Visitor #4
-- Select an option --
Yes
No
No Individual Sessions held this month
-- Select an option --
Yes
No
No Group Sessions held this month
-- Select an option --
On leave
Did not have time to attend
OTHER
(Please detail in comments)
Home Visitor #5
-- Select an option --
Yes
No
No Individual Sessions held this month
-- Select an option --
Yes
No
No Group Sessions held this month
-- Select an option --
On leave
Did not have time to attend
OTHER
(Please detail in comments)
Home Visitor #6
-- Select an option --
Yes
No
No Individual Sessions held this month
-- Select an option --
Yes
No
No Group Sessions held this month
-- Select an option --
On leave
Did not have time to attend
OTHER
(Please detail in comments)
Home Visitor #7
-- Select an option --
Yes
No
No Individual Sessions held this month
-- Select an option --
Yes
No
No Group Sessions held this month
-- Select an option --
On leave
Did not have time to attend
OTHER
(Please detail in comments)
OTHER Reason for not attending Reflective Supervision Session