Administering and Evaluating PCAP: Data Collection Forms

Timeline for PCAP Evaluation Form Administration (flow chart)

Client Intake

Intake ASI

ASI Intake Manual

UW‐ASI Intake Form, Part A

UW ASI Intake Interview Part B (Target Child Information)

Native American Tribal Affiliation

Biological Children at Enrollment

Biological Child at Enrollment Coding Master

Difference Game

Difference Game Instructions

Difference Game Data Entry Form

Difference Game Coding Master

Difference Game Templates ‐ English

Difference Game Templates ‐ Spanish

Difficult Life Circumstances (DLC)

Native American Questionnaire (for Native American clients only, optional)

Weekly

Weekly Advocate Time Summary Sheet

Time Summary Coding Master

Monthly

Monthly Update

Monthly Update Coding Master

Every 4 Months

Goal Assessments (Baseline to 36 Months)

Goal Assessment Coding Master

Every 6 Months

Biannual Documentation of Client Progress

Biannual Assessment Coding Master

If Event Occurs During Program

Notification of Subsequent Birth

Subsequent Birth Coding Master

Client Status: Program Exit Definitions and Protocols

Client Transfer Protocols

Client Assignment and Transfer Form

False Enrollment/Withdrawal

Notification of Client Court Activity (Drug Court/Family Treatment Court)

Notification of Client Housing Activity (PCAP Housing)

Update of Mental Health Diagnosis

Mental Health Diagnosis Coding Master

FASD/Neurocognitive Impairment Update Form

FASD/Neurocognitive Impairment Coding Master

Notification of Death

Client Exit

UW ASI Exit Manual

UW ASI Exit Interview

Advocate‐Client Relationship Inventory

Client Exit Close‐out Form

Client Lost Post Exit

Advocate Accounting of Tracing Activity of Missing Post‐Exit Client

Administering and Evaluating PCAP: Data Collection Tracking Forms

Advocate Time Summary Tracking Grid

Baseline Forms Tracking

Data Tracking Instructions

Monthly Tracking Forms

Subsequent Birth Tracking

Tracking Sheet: 4 and 6 Months