Family Start Transfer - Early Start Project Christchurch NZ

Family Start Transfer Report to Early Start

To be completed when a Family Start family requests a transfer to the Early Start programme.

Family Start Transfer Report

Referral form completed by a Family Start for family transferring to Early Start.

Step 1 of 7 - Family Start Details

Date of Referral

Family Start site being transferred from(Required)

Family Support Worker/Whānau Āwhina:(Required)

First Name Last Name

Family Support Worker's Email(Required)

Transfer Information

Address each item and provide a short comment about any issue noted. Rate the severity of the challenge from the client’s perspective and your perspective.

How to Rate

3: Many challenges, concerns and issues identified. The home/family situation is problematic and difficult to manage. Child/ren’s ability to flourish is or can be seriously compromised. 2: Some challenges identified, concerns that child/ren are at risk Parent/s struggling to ensure that their child/ren are flourishing. 1: Few concerns identified. Parent/s manage well and are ensuring that their child/ren are flourishing well.

Child Health Monitoring

Immunisation & WCC are up to date. Enrolled with a GP practice, Child/ren are healthy. Any health issues are immediately attended to. Age appropriate dental checks completed.

Child Health Monitoring Comment

Child Development

Child is developing well. Reaching milestones. Language and motor development is age appropriate. Behaviour is within age appropriate expectations

Child Development Comment

Child Safety

Home environment is safe. Child is always transported in an age appropriate car seat. Outside play area is safe. Parent is aware of safety issues and takes appropriate actions to ensure safety

Child Safety Comment

Parent – Child Interactions

Parent child interactions are warm, respectful and age appropriate. Parent makes every effort to understand and attend to the child/ren’s needs

Parent – Child Interactions Comment

General Child rearing

Good daily routines, parent/s are consistent with boundary setting, children are well cared for e.g. good hygiene, child/ren suitably clothed for the weather, consistent age appropriate bed time routines.

General Child rearing Comment

Child behaviour management

Parents are able to manage their child/ren’s behaviour using positive parenting strategies. Children are responding well. No/few minor behavioral issues present

Child behaviour management Comment

Pre-school attendance

Once child is ready for pre school, parent/s ensure that child/ren attend on a regular basis. Child/ren are suitably dressed and have age appropriate food provided.

Pre-school attendance Comment

Family Nutrition

Parent’s have a good knowledge of and are making good choices regarding family healthy nutrition. Regular meal times are observed. Sugar free drinks are available

Family Nutrition Comment

Smoke free home or car

Parent/s ensure the child is protected from passive smoke.

Smoke free home or car Comment

Family Planning /Sexual Health

Parent/s use contraception. Additional children are planned. Parent/s are aware of sexually transmitted diseases and are practicing safe sex

Family Planning /Sexual Health Comment

Parental Dependencies

No dependencies identified. Responsible use of alcohol. No illicit or non prescribed drug abuse. No gambling issues.

Parental Dependencies Comment

Parental Mental Health

Parent/s are not suffering any mental health issues. If mental health issues are present, parent/s are in treatment and compliant to their treatment regimes and responding to prescribed treatments. Mental ill health symptoms are not evident and parent/s are coping well.

Parental Mental Health Comment

Family Relationships

Family relationships are warm, respectful and supportive. The wider whanau environment is affirmative with realistic & positive aspirations for their children.

Family Relationships Comment

Parental Law breaking behaviours

Parent/s are law abiding. Not involved in any criminal activity.

Parental Law breaking behaviours Comment

Home Management

Children are raised in a well managed home situation. No/few housekeeping issue e.g. few home hygiene issues, no hoarding, no chaotic living spaces.

Home management Comment

Housing situation

The family is living in an adequate, suitable house. The house meets their needs.

Housing Situation Comment

Economic Circumstances

Parents are managing their income/budget well. No benefit fraud. Indebtedness is in keeping with their income.

Economic Circumstances Comment

Other Concerns

Please describe any other challenges or concerns we should be aware of.

Referrer Statement & Signature

Referrer's Name:(Required)

Referrer's Signature(Required)

Draw your signature using either a mouse, digital pen or finger.

Family Start Transfer Report to Early Start

Family Start Transfer Report

Parent / Primary Caregiver

Partner Details

Enrolled Child's Details

Siblings / Dependents

Significant other (whanau and friends) contact details:

Family Information

Transfer Information

How to Rate

Referrer Statement & Signature