PROTECTIVE ACTIONS Referral Source: Risk Level Opening Initial Service Secondary Service CPI (from CSA) Risk Reason Reason Community Provider (with CPI) Low Low Case Manager Medium Medium Hotline High High Provider (re-staff) Caregiver (re-open) Initial Referral Date: V. Staffing Notes:
PROTECTIVE ACTIONS Referral Source: CPI Community Provider (with CPI) Case Manager Hotline Provider (re-staff) Caregiver (re-open) Initial Referral Date: Risk Level (from CSA) Low Medium High Opening Risk Low Medium High Initial Service Reason Secondary Service Reason V. Staffing Notes:
CBCStaffing.docx