(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.
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E3-04
For children who are seeking DDSN eligibility, and family training is identified as a need, the Early Interventionist has 45 days from date of eligibility date to complete the FSP
E3-24
Service Notes documented why and how the Early Interventionist participated in meetings/appointments on the child's behalf
E3-06
The Parent/Caregiver was provided a copy of the Plan
E3-25
If applicable documentation in service notes indicates that the case was closed
E3-02
There is a Service Justification form in the file for any child 5 years of age or older being served in Early Intervention
E3-22
If less than 2 hours per month of Family training is identified on the FSP there is an approved Service Justification form in the file
E3-19
Family Training activities should vary. Activities planned must be based on identified outcomes on the IFSP
E3-23
If the Early Interventionist is unable to provide Family training for an extended period of time (more than a month) was the family offered a choice of an alternate Early Interventionist
E3-10
FSP includes current information relating to vision, hearing, medical, and all areas of development to include health
E3-15
Assessments are completed every 180 days, or as often as changes warrant
E3-14
If the child's IFSP indicates the need for more than 4 hours per month of Family Training, the service notes indicate that inforamtion has been sent to the Office of Children's Services for approval
E3-08
The Choice of Early Intervention Provider is offered annually
E3-07
FSP six-month review was completed within 180 days of the FSP
E3-13
FSP "Other Services" reflects current services
E3-16
Family Training is provided according to the frequency determined by the team and as documented in the Other Services section of the FSP
E3-11
Outcomes are based on identified needs and the team's concerns relating to the child's development
E3-12 Outcomes are/have been addressed by the Early Interventionist
E3-03
Transition to other services or settings is coordinated
E3-26
Medical necessity form was completed prior to any services being reported
E3-20
Family Training activities correspond to outcomes on the FSP outcomes page
E3-01
Service Agreement signed and present in file
E3-21
Time spent/reported preparing for a Family Training visit corresponds with the activity planned
E3-17
Family training summary sheets include goals and objectives for each visit as well as follow-up objectives for the next visit
E3-05
Family Service Plan (FSP) is completed annually
