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2000 Embarcadero Cove, Suite 400
Oakland, CA 94606
510-567-8100 / TTY 510-533-5018
Karyn L. Tribble, PsyD, LCSW
Page 1
ak 4/4/2024
ICC/IHBS Child and Family Team (CFT)
Client Care Plan and Meeting Minutes
Section A
Client Name: Meeting Date Next Meeting Date
Intensive Care Coordinator CFT Facilitator Provider Agency
Most recent CANS completion
date:
As of meeting date, does client meet Katie A. Subclass/ICC criteria? Yes ☐ No ☐
Team Members Present Relationship Phone and/or Email
The ICC Coordinator will distribute a copy of the completed Client Care Plan to the participants
listed above. Each provider must save an electronic copy of the Client Care Plan in the client’s
chart.
2000 Embarcadero Cove, Suite 400
Oakland, CA 94606
510-567-8100 / TTY 510-533-5018
Karyn L. Tribble, PsyD, LCSW
Page 2
ak 4/4/2024
Section B
HOPE STATEMENT – YOUTH AND FAMILY GOAL/DESIRED OUTCOME
STRENGTHS: What strengths in the child/youth (or caregiver) help inform a strengths-based approach? What are the protective factors? Highlight actionable items. (Minimum 2)
CHALLENGES - What areas of a child/youth’s life are impacted (e.g. family, social, community
and academic) as a result of the client’s behaviors and symptoms? Highlight actionable needs. (Minimum 2)
PREVIOUS TASK REVIEW
2000 Embarcadero Cove, Suite 400
Oakland, CA 94606
510-567-8100 / TTY 510-533-5018
Karyn L. Tribble, PsyD, LCSW
Page 3
ak 4/4/2024
REFER FOR IHBS:
☐ Team discussed eligibility to receive IHBS, current needs and timing of adding IHBS
☐ IHBS being provided
☐ Client and family have declined IHBS at this time. Team to reassess, as needed
☐ Referral not needed at this time
☐ Referral to be submitted. List behaviors to be addressed:
SAFETY/RISK: A separate Safety Plan is required if there is a significant risk/concern in past 90 days
DISCUSSION ITEMS: Specific agenda items gathered from team members. This may include
brainstorming, decision-making, and key discussion points.
Specify who else client or family would want at NEXT CFT Meeting
2000 Embarcadero Cove, Suite 400
Oakland, CA 94606
510-567-8100 / TTY 510-533-5018
Karyn L. Tribble, PsyD, LCSW
Page 4
ak 4/4/2024
Section C: Goals reviewed during CFT Meeting
Area of
Need Social,
Education,
Vocation,
Physical or
Mental
Health,
Independent
Living, etc.
Does it
require a
change to
CANS
action
item?
Goals/Objectives
to address need
(must be measurable)
Date
Added
to Plan
Task to address
need
Next steps
Who/
When
Progress
Status
Completed,
New, or
In-Progress
Yes ☐
No ☐
Yes ☐
No ☐
Yes ☐
No ☐
Yes ☐
No ☐
Yes ☐
No ☐
Yes ☐
No ☐
2000 Embarcadero Cove, Suite 400
Oakland, CA 94606
510-567-8100 / TTY 510-533-5018
Karyn L. Tribble, PsyD, LCSW
Page 5 ak 4/4/2024
Transition Plan from ICC/IHBS Services (Please be specific)
Anticipated Discharge
Date
Section D Indicate if the following are coordinated with this Client Care Plan
PROBLEM LIST /
SERVICE PLAN Yes No N/A If No, explanation:
Problem List(s) ☐ ☐ ☐
CANS ☐ ☐ ☐
Child Welfare Case Plan ☐ ☐ ☐
Education (e.g. IEP) ☐ ☐ ☐
Probation ☐ ☐ ☐
Other: ☐ ☐ ☐