| Case Information |
|
Case Name
|
| |
Goldhammer, Nicole
|
|
Case #
|
| |
841994
|
|
Case Type
|
| |
ISRS
|
| Caseworker Information |
|
Caseworker Name
|
| |
Alicia Davis
|
|
Phone
|
| |
(971) 293-9303
|
|
Email
|
| |
Alicia.R.Davis@odhs.oregon.gov
|
| Supervisor Information |
|
Supervisor Name
|
| |
Lisa Warwick
|
|
Phone
|
| |
(503) 953-6926
|
|
Email
|
| |
Lisa.Warwick@odhs.oregon.gov
|
| Participant Info |
|
How many Participants ?
|
| |
2
|
|
Primary Participant Name
|
| |
Nicole Burnham
|
|
Primary Participant #
|
| |
2344381
|
|
Gender
|
| |
Female
|
|
Date of Birth
|
| |
07/31/1989
|
|
Age
|
| |
35
|
|
Ethnicity
|
| |
Indigenous/Native American
|
|
Address
|
| |
2862 SE Quail Dr
Gresham, Oregon 97080
United States
Map It
|
|
Primary Participant Relationship to Case
|
| |
Child
|
|
Participant Name 2
|
| |
Bo Burnham
|
|
Participant 2 #
|
| |
11337770
|
|
Participant 2 Gender
|
| |
Male
|
|
Participant 2 Date of Birth
|
| |
03/20/2025
|
|
Participant 2 Age
|
| |
0
|
|
Participant 2 Ethnicity
|
| |
Indigenous/Native American
|
|
Participant 2 Relationship to Case
|
| |
Child
|
|
Start Date of Referral
|
| |
04/04/2025
|
|
End Date of Referral
|
| |
04/14/2025
|
| Requested Daily Schedule |
|
Monday
|
| |
3xday
|
|
Tuesday
|
| |
3xday
|
|
Thursday
|
| |
3xday
|
|
Wednesday
|
| |
3xday
|
|
Friday
|
| |
3xday
|
|
Saturday
|
| |
3xday
|
|
Sunday
|
| |
3xday
|
|
Attach recent safety plan
|
| |
|
|
Reason for Referral + Desired Outcome
|
| |
The agency is requesting daily checks to ensure the children’s safety and wellbeing in Nicole’s care, and ensure that she is not having unsupervised contact with Matthew. IF Matthew and Nicole are in the same location, they are to have a SSP with them while they are present with their children for visits until care is established
Skill building:
Consistency/Routines
|
|
Referral Status
|
| |
Active
|
|
Assign To Group:
|
| |
- ADMIN
- 24 HR CASE GROUP
- ISRS
|
