Your form "Client Referrals " has received the following response: 
Submitted on: 07/11/2019 03:35:50 PM
Completion time: 5 hr. 18 min. 19 sec.   10/5/2020 - 12:51-# busy, #buzy, 21:26-# busy, 21:27-answered/hung up

Client Name and Address		Susana Ruiz
				(806) 747-4931
				jclark9852@gmail.com
				3109 DARTMOUTH ST
				TX
				Lubbock 
				79415
				Lubbock

Client's Age at Referral: 71
DOB: 01-19-1948
Client's Gender: Female
Client's Ethnicity: Hispanic

Is this a hospice patient? No
Is this a dialysis patient? Yes
Is this a handicapped person living alone? No
Did this person serve in the military? No

Is there a financial need, based on your agency's guidelines? Yes
Does the Client Own or Rent their home? Own

Caretaker /Other Contact  
Sandra       (806) 831-5907

Where is the ramp needed? (Be specific: front of house, side door, etc...) 
front of the home. 

Provide a brief description of the obstacle(s) 
(e.g. a door threshold, a single step, a mobile home with three steps, etc...)
This home has one step but the distance between the step and existing porch causes a hazard for AV. 

Provide details of the client's mobility that are relevant to a ramp 
(e.g. walking, assisted walking, manual wheelchair, powered wheelchair, etc.). 
Also include a prognosis if this is expected to change.
CL uses a walker and has gait issues that would make it easier to transition down a ramp verses 
stepping down from her porch. 

Is there an existing dangerous ramp at the client's home? 

Referring Social Worker Information
James Clark
Adult Protective Services. 
(806)252-2283
james.clark2@dfps.state.tx.us