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Triennial Review

Local Health Department Reviews

A comprehensive review of local county health departments is conducted every three years for most programs. The results of the review, including commendations, compliance findings, and recommendations are communicated to the Local Public Health Authority and the County Health Administrator. This page contains the tools used for those reviews.

Triennial Review Tools

All "Word" forms contained on this page are fillable forms.


Word  PDF 

Approved 5/2014

Babies First!

Word  PDF 

Approved 4/2013

Civil Rights

Word  PDF 

Approved 8/15/12

Communicable Disease

Word PDF 

Approved 5/16/13

Drinking Water

Word  PDF 

Approved 6/10/13

Family Planning Record Review

Word PDF  May 2011

CCare Chart Audit

Word PDF  Jan 2010

Family Planning FPEP Chart Audit

Word PDF 
Fiscal Review County Word PDF  July 2014
Fiscal Review Non-Profit Word PDF September 2014

Food, Pool and Lodging Health & Safety - Environmental Health 

Word  PDF  August 2013

Food, Pool and Lodging Health & Safety - Environmental Health Program Protocol

Word  PDF 

August 2013

Health Officer

Word  PDF

Approved 5/2014

Healthy Communities Implementation Word PDF May 2013

HIV Care and Treatment

Word  PDF 

Approved 1/2014

HIV Prevention

Word PDF  Revised 9/2011
Laboratory Word PDF Approved 5/2014


Word  PDF 

Approved 10/2014

MCH Record Review

Word  PDF  Updated 3/2012
Nuse Family Partnership Word PDF Approved 8/2014


Word  PDF 

Approved 3/2013

Public Health Emergency Preparedness Word PDF July 2014
Reproductive Health Word PDF February 2014


Word  PDF 

Approved 7/22/10

Tobacco Prevention & Education Program (TPEP) Word PDF May 2013

Tuberculosis Review

Word  PDF 

Revised 5/22/13

Tuberculosis Chart Audit

Word  PDF  Revised 5/22/13

Vital Records

Word  PDF 

Approved 11/6/2014


Word PDF 

Revised 1/13/14

WIC Breastfeeding Peer Counseling Program

Word PDF 

Revised 1/13/14

WIC Farm Direct Nutrition Program

Word PDF 

Revised 1/13/14