Clerk Civil
Resume:
ESS CARE COORDINATION PLAN
Plan for: Mary Ann Vicaria Hope Navigator: Lynda Anglade Date: 10/11/2022 Expected completion GOAL ONE ACTION STEP DESCRIPTIONS WHO’S RESPONSIBLE DATE TO BEGIN
DUE DATE COMPLETED
Goal statement: Client to apply for
rental assistance payment.
Hope Navigator to provide Partner Referral
for rental assistance payment.
HN 10/10/2022 10/14/2022
Hope Navigator to provide online link to
client.
HN 10/10/2022 10/14/2022
Hope Navigator to inquire on progress and if
additional assistance is needed.
HN 10/17/2022
List Resources: Partner Referral,
address to bring physical application,
and online link.
Outcomes: Client to be approved for
rental assistance payment.
Client to apply for rental assistance. Mary Ann Vicaria 10/11/2022 10/17/2022 Client to provide required documents to
complete application process.
Mary Ann Vicaria 10/17/2022 10/24/2022
Client to contact Hope Navigator and provide
status update.
Mary Ann Vicaria 10/17/2022
GOAL TWO ACTION STEP DESCRIPTIONS WHO’S RESPONSIBLE DATE TO BEGIN
DUE DATE COMPLETED
Goal statement: Client to call and
register for shelter.
Hope Navigator to provide Partner Referral
for shelter registration.
HN 10/10/2022 10/14/2022 10/10/2022
Hope Navigator to inquire on progress and if
additional assistance is needed.
HN 10/17/2022
Client to register for shelter. Mary Ann Vicaria 10/24/2022 10/28/2022 List Resources: Partner Referral and
phone number.
Outcomes: Client to obtain shelter if
rental assistance is not approved.
Client to follow instruction received from
shelter registration.
Mary Ann Vicaria TBA
Client to update Hope Navigator with status
of barrier.
Mary Ann Vicaria TBA
GOAL THREE ACTION STEP DESCRIPTIONS WHO’S RESPONSIBLE DATE TO BEGIN
DUE DATE COMPLETED
Goal statement: Client to apply for
STS transportation.
Hope Navigator to provide Partner Referral
for STS transportation.
HN 10/10/2022 10/14/2022 10/10/2022
ESS CARE COORDINATION PLAN
2
Hope Navigator to inquire on progress and if
additional assistance is needed.
HN 10/31/2022
Client to schedule doctor appointment for
completion of form.
Mary Ann Vicaria 10/17/2002 10/24/2022
List Resources: Partner Referral,
application form, address, and phone
number with instruction.
Outcomes: Client to be approved for
STS transportation.
Client to complete application section. Mary Ann Vicaria 10/24/2022 10/31/2022 Client to submit application and obtain
appointment for screening.
Mary Ann Vicaria TBA
Client to attend appointment for screening.
Client to provide any additional information
requested.
Client to contact HN and provide update.
Mary Ann Vicaria
Mary Ann Vicaria
TBA
I understand this is a voluntary program, and I agree to participate. Participation includes following through with the referrals given and remaining in contact with the Care Coordinator.
Customer Signature Date
Lynda Anglade 10/11/2022
Hope
Navigator
Date
Plan for: Mary Ann Vicaria Hope Navigator: Lynda Anglade Date: 10/11/2022 Expected completion GOAL FOUR ACTION STEP DESCRIPTIONS WHO’S RESPONSIBLE DATE TO BEGIN
DUE DATE COMPLETED
Goal statement: Client to apply for
bus pass.
Hope Navigator to provide Partner Referral
for a bus pass with Golden Pass application.
HN 10/10/2022 10/14/2022 10/11/2022
Hope Navigator to inquire on progress and if
additional assistance is needed.
HN
Client to obtained eligibility letter for
benefits.
Client to complete Golden Pass application.
Mary Ann Vicaria
Mary Ann Vicaria
11/01/2022
11/01/2022
11/07/2022
11/07/2022
List Resources: Partner Referral and,
address.
Outcomes: Client to obtain reduced
bus pass.
Client to go and apply for bus pass. Mary Ann Vicaria 11/07/2022 10/11/2022 Client to contact Hope Navigator to provide
update status.
Mary Ann Vicaria 11/14/2022
ESS CARE COORDINATION PLAN
3
GOAL FIVE ACTION STEP DESCRIPTIONS WHO’S RESPONSIBLE DATE TO BEGIN
DUE DATE COMPLETED
Goal statement:
Basic Need: Hygiene Pending
List Resources and desired outcomes
GOAL SIX ACTION STEP DESCRIPTIONS WHO’S RESPONSIBLE DATE TO BEGIN
DUE DATE COMPLETED
Write goal statement here
List Resources and desired outcomes
I understand this is a voluntary program, and I agree to participate. Participation includes following through with the referrals given and remaining in contact with the Care Coordinator.
Customer Signature Date
Lynda Anglade 10/11/2022
Hope
Navigator
Date
Plan for: Care Coordinator: Date: Expected completion GOAL SEVEN ACTION STEP DESCRIPTIONS WHO’S RESPONSIBLE DATE TO BEGIN
DUE DATE COMPLETED
Write goal statement here
List Resources and desired outcomes
Contact this candidate