Care Plan Evaluation Form GRADING CRITERIA: A score of 1 will be given if no significant errors are identified. A score of % will be given if 1-3 significant errors are identified, A score of O will be given if required information is missing of deemed inaccurate by the instructor. -L 1. Patient informations present a 2. Medical History findings are present. AL 5 mesic! stor vise are identi 4 social and Dena histor fnings are present LS. Social and Dental history risks are identified. 16. Dental Examinations findings are present. 12, beta examination risk are present LB. Plaque score calculated correctly 1s, pleesng score calculated corety 1.10. Periodontal information assessed correctly. “11. dental hygiene diagnosis problems stated correct 112. Dental hygiene diagnosis risk factors or etiology stated. \ 443. Planned intervention education stated clearly for each clinical finding, 1.14. planned intervention ora ysiene i appropiate foreach clinical ning L.1s, 1161 sated cleory 15.516 ages statev appropriate for i762 Acap. 1162 stated clear 18, 516 3 goals stated appropriate for LTG 2 119. 116 3 stated clearly -{ 20576 3 goals stated appropriate for LTG 3.