IDA Infant Mental Health Special Interest Group Survey to Identify Infant and Early Childhood Mental Health Resource Agencies Survey to Identify Infant and Early Childhood Mental Health RESOURCE AGENCIES 1. What is the name of the agency? Kings County Office of Education (KCOE) - Infant Program 2. What category of IMH Resource Agency best describes your agency? ___ State or Statewide Agency ___ Training/Technical Assistance Agency (NOTE: Please complete the IDA survey designed for IMH/ECMH Training Programs, rather than this survey) ___ Direct Service Provider ___ Funder of Direct Services: ___ Public Agency (County Mental Health, Social Services, etc.) ___ First 5 Agency ___ Regional Center _X_ Education/Special Education ___ Foundation ___ Other Funder: __________________ ___ Resource and Referral Agency ___ Policy Development Agency ___ Research Agency ___ Other type of IMH Resource Agency: _______________ 3. What geographical area of California is served by the agency? ___ Statewide agency ___ Regional agency (more than 1 county) _X_ County Agency ___ Local Community Agency 4. What is the primary purpose or mission of the agency? To provide weekly home based infant programs, for children birth to three, who are orthopedically, visual or hearing impaired. ???? 5. What are the strengths and/or unique features of the agency related to infant/early childhood mental health that the field should be aware of? We work with an agency called UCP Child Development Center. They hire a part time social worker (6 hours and 1 day a week) who provides ??? to come and work at UCP. They talk to parents and offer information. 6. What are the agency’s main funding sources? Department of Education ????? 7. If applicable, what ages of children are served by the agency? _X_ birth to 3 years ___ 3 to 5 years ___ children of all ages 8. If applicable, approximately how many children are served by the agency? birth to 3 years: per month? 52 per year?_______ 3 to 5 years: per month? n/a per year? n/a IDA Infant Mental Health Special Interest Group Survey to Identify Infant and Early Childhood Mental Health Resource Agencies children of all ages: per month? * per year? * *Assess approximately 20 infant/toddlers per month. Supervise 32 home visits weekly. ??? 9. Who is eligible for your agency’s services, and how is eligibility determined? This question was not on the original survey that was submitted. Do we follow up? 10. What are the agency’s activities related to infant and early childhood mental health? _X_ prevention/early intervention _X_ assessment ___ treatment ___ consultation _X_ fund direct services ___ training/technical assistance _X_ resource and referral ___public policy ___ research ___ other: (please describe) 11. If your agency is a direct service provider, please describe: your agency’s target population(s): Low incidence: orthopedic, vision, or hearing impaired. your agency’s services: Home visiting once a week for 45 minutes. We collaborate with UCP and their OT, PT, and ST. your agency’s staffing: Special education teacher and 2 assistants 12. Does your agency have infant/early childhood mental health personnel on staff? Not at KCOE but at UCP Child Development Center, they have hired a social worker (???) who ??? with parents ????? 13. Do you provide infant or early childhood mental health treatment as part of your agency’s services, or do you refer to other treatment providers? We refer to other providers. 14. Please provide contact information for further information about your agency’s services: Website: In process of developing <kingsnet.kings.k12.ca.us> Contact person: Name: Jan Torgeson e-mail address: jtorgeso@kings.k12.ca.us Phone number: 559-584-1441 x2614 Fax number: 559-589-9611 Mailing Address: 1144 W. Lacey Blvd., Hanford CA 93230 15. Is your agency interested in collaborating/networking with the IDA Infant Mental Health Interest Group? Yes. If yes, please describe your agency’s particular collaboration interests, if any: Regarding assessments 16. Please provide contact information for a liaison to this group: Name and Title (if any): Jan Torgeson, Special Education Teacher Organization:Kings County Office of Education (KCOE) - Infant Program IDA Infant Mental Health Special Interest Group Survey to Identify Infant and Early Childhood Mental Health Resource Agencies Mailing Address: 1144 W. Lacey Blvd., Hanford CA 93230 E-mail address: jtorgeso@kings.k12.ca.us Phone number: 559-584-1441 x2614 Fax number: 559-589-9611 17. May we include this information about the program on the IDA IMH Resource Directory Webpage? Yes 4/06