HFM Staff Supervision Note Date: ________ Home Visitor: _______ Supervisor: ___________ Topics Discussed: (Check all that apply. Document content of discussion below): HV strengths Documentation HV Safety ☐ ☐ ☐ Professional goals Caseload/case weight Boundaries ☐ ☐ ☐ Training (e.g. integrating new Quality assurance (e.g. HVCR, HV Personal issues (e.g. ☐ ☐ ☐ information, interests/needs) observation, QA calls) childcare, transportation) Skills building Personnel (attendance, timeliness) Self-care, support ☐ ☐ ☐ Groups Schedule Transition planning ☐ ☐ ☐ Team dynamics Community outreach Cultural exploration ☐ ☐ ☐ Agency/program updates Other, ☐ ☐ Reflection on work/FAN: ________________________________________________________________ Supervision Content: ___________________________________________________________________
HFM Staff Supervision Note Date: ________ Home Visitor: _______ Supervisor: ___________ Topics Discussed: (Check all that apply. Document content of discussion below): ☐ HV strengths ☐ Documentation ☐ HV Safety ☐ Professional goals ☐ Caseload/case weight ☐ Boundaries ☐ Training (e.g. integrating new information, interests/needs) ☐ Quality assurance (e.g. HVCR, HV observation, QA calls) ☐ Personal issues (e.g. childcare, transportation) ☐ Skills building ☐ Personnel (attendance, timeliness) ☐ Self-care, support ☐ Groups ☐ Schedule ☐ Transition planning ☐ Team dynamics ☐ Community outreach ☐ Cultural exploration ☐ Agency/program updates ☐ Other, Reflection on work/FAN: ________________________________________________________________ Supervision Content: ___________________________________________________________________
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