Attachment H-Management Review Tool.pdf
PDF 94 KB Posted
- Attached to
- Breastfeeding Peer Counseling Services
- Solicitation number
- 25RFP-25-0904004-005
- Issued by
- Kingsbury County, South Dakota
About this file
This document is Attachment H - Management Review Tool for the South Dakota Department of Health WIC Program's Breastfeeding Peer Counseling Services contract. The tool outlines six key performance expectations for peer counselors, including: timely participant contact after referral, adherence to contact schedules, documentation in SDWIC-IT within one week of contact, providing updates to WIC staff on referrals, use of approved educational materials, and working within established scope of practice while making appropriate referrals. The form includes spaces for "Yes/No" responses and comments for each expectation.
The document appears to be an evaluation or compliance monitoring tool, with blank spaces for participant name, date, and two additional unlabeled expectations (#7 and #8). This management review tool would be used to assess peer counselor performance and ensure quality control in delivering breastfeeding support services to WIC program participants. The form's structure suggests regular performance monitoring and documentation requirements for the peer counseling program.
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Text version
Attachment H Management Review Tool
Participant Name:
Date:
Counselor Expectations Yes No Comments
1. Peer Counselor contacted mother within established timeframe after referral.
2. Peer Counselor contacts mother according to the Schedule of Contacts.
3. Peer Counselor documents in SDWIC-IT within 1 week of contact.
4. Peer Counselor provides updates to WIC staff when participant has been referred.
5. Peer Counselor uses approved materials to provide education to participants.
6. Peer Counselor works within the established scope of practice and makes appropriate referral.
7.
8.
File details come from the government source that posted it. Updated .