Site: Home Visitor Name: Month: Date: Child's Name (Last, First) M T W Th F M T W Th F Notes/Follow-up/Action Taken: 1 2 3 4 5 6 7 8 9 10 11 12 Documenting Absences: Note: Absent Codes will all be NUMBERS Codes Present= use the letter code for Absent Codes Health check 1= Approved Leave 2= Bereavement 3. Doctor/Dentist Appointment 0 = Not Scheduled Of Absence 4= Family Situation 5= Illness 6= Hospital 11= Unexcused Absence 7= Injury 8= Parent Appointment 9= No Transportation 12= Canceled (snow, power 10= No one available for pick-up or drop-off 15 = Socialization Time Conflict (Other than work) outage, water outage, fire, etc.) 16= Work Conflict 17= Personal Reason, would not like to attend 18= unable to attend due to weather conditions
Site: Home Visitor Name: Month: Date: Child's Name (Last, First) M T W Th F M T W Th F Notes/Follow-up/Action Taken: 1 2 3 4 5 6 7 8 9 10 11 12 Documenting Absences: Note: Absent Codes will all be NUMBERS Codes Present= use the letter code for Health check Absent Codes 0 = Not Scheduled 1= Approved Leave Of Absence 2= Bereavement 3. Doctor/Dentist Appointment 11= Unexcused Absence 4= Family Situation 5= Illness 6= Hospital 12= Canceled (snow, power outage, water outage, fire, etc.) 7= Injury 8= Parent Appointment 9= No Transportation 10= No one available for pick-up or drop-off 15 = Socialization Time Conflict (Other than work) 16= Work Conflict 17= Personal Reason, would not like to attend 18= unable to attend due to weather conditions
21%20EHS%20Socialization%20Attendance%20Summary%20%209-10-18.docx