Conduct a basic dental screening of 01/01/19- Signed consent forms, summary of 6.1.5 students to determine dental status with 06/30/22 survey results parental permission. (optional) Schedule time at school site to conduct 01/01/19- Correspondence with school 6.1.6 screening with those children who submitted 06/30/22 signed consent forms. Conduct screening with teachers, site 01/01/19- Number of children screened, 6.1.7 personnel, and volunteers. 06/30/22 Determine number of children that need 01/01/19- Data captured in report to CDPH dental sealants and the number of sealants 06/30/22 6.1.8 per Follow-up with teachers to ensure notices were sent home. 6.1.9 Annually, facilitate dental sealant placement 01/01/19- Schedule of events, number of by a dentist, registered dental hygienist in 06/30/22 children served, number of sealants alternative practice or registered dental provided hygienist at provider site, or will sealants on a minimum of 5% of targeted children with signed parental consent form at a coordinated sealant event with teachers, site personnel, and volunteers. 6.1.10 Annually, complete sealant retention checks 01/01/19- Summary of follow-up activities, on a minimum of 10% of the children who 06/30/22 number of children who received received sealants during the school year. retention checks, screening forms on file
6.1.5 Conduct a basic dental screening of students to determine dental status with parental permission. (optional) 01/01/19- 06/30/22 Signed consent forms, summary of survey results 6.1.6 Schedule time at school site to conduct screening with those children who submitted signed consent forms. 01/01/19- 06/30/22 Correspondence with school 6.1.7 Conduct screening with teachers, site personnel, and volunteers. 01/01/19- 06/30/22 Number of children screened, 6.1.8 Determine number of children that need dental sealants and the number of sealants per Follow-up with teachers to ensure notices were sent home. 01/01/19- 06/30/22 Data captured in report to CDPH 6.1.9 Annually, facilitate dental sealant placement by a dentist, registered dental hygienist in alternative practice or registered dental hygienist at provider site, or will sealants on a minimum of 5% of targeted children with signed parental consent form at a coordinated sealant event with teachers, site personnel, and volunteers. 01/01/19- 06/30/22 Schedule of events, number of children served, number of sealants provided 6.1.10 Annually, complete sealant retention checks on a minimum of 10% of the children who received sealants during the school year. 01/01/19- 06/30/22 Summary of follow-up activities, number of children who received retention checks, screening forms on file
Document%20G%20-%20Work%20Plan%20(Template)%20%208-23-2017.docx