Patient Name: Josephine

Patient Information:

Patient ID: 10036
Patient First Name: Josephine
Patient Date of Birth: 12-02-2024
Gender: Female
Assigned Office: NB1 east side
Primary Care Physician: Karina L, Cecilio
Patient Status: Active

Primary Attendance / Assigned Therapists:

ST - Speech Therapy:
FD - Feeding Therapy:
OT - Occupational Therapy:
PT - Physical Therapy:

Patient Primary Authorizations:

Auth. IDStatusStart DateEnd DateInsuranceST-UnitsFD-UnitsOT-UnitsPT-Units
23602Active03-19-202604-17-2026Tricare Prime0001

Physical Therapy Evaluation:

IDDateTypeEvaluation Diagnosis
33203-26-2026Physical Initial EvaluationM62.81
Physical Background History: Initial Evaluation with parent present throughout the evaluation. Parent consented to physical therapy evaluation today. Parent participated in PT evaluation to provide pertinent information for the assessment. Patient is a 15 month old female referred to physical therapy with developmental delay in Gross Motor skills. Patient was seen on March 26, 2026 for a scheduled physical therapy evaluation to assess current level of function. Patient born full term without complications throughout pregnancy. Patient was diagnosed with Laryngomalacia and was seen by ST for a period of time. Currently receiving OT services to help developmental delay. Parental Report/Primary Concern/Goals: Parent would like to see child crawl and walk
Physical Background History: Initial Evaluation with parent present throughout the evaluation. Parent consented to physical therapy evaluation today. Parent participated in PT evaluation to provide pertinent information for the assessment. Patient is a 15 month old female referred to physical therapy with developmental delay in Gross Motor skills. Patient was seen on March 26, 2026 for a scheduled physical therapy evaluation to assess current level of function. Patient born full term without complications throughout pregnancy. Patient was diagnosed with Laryngomalacia and was seen by ST for a period of time. Currently receiving OT services to help developmental delay. Parental Report/Primary Concern/Goals: Parent would like to see child crawl and walk
Physical Surgical History: Endoscopy
Physical Medical History: 0. Laryngomalacia
Physical Medications: None
Patient/Family Education: Discussed the finding of the examination, reviewed the POC and goals with the parent. Discussed activities/strategies available to address current concerns and how to assist patient in achieving optimal developmental milestones. Parent states understanding and agrees to provide support at home in order to progress outcomes for patient. Parent provided opportunity to ask questions and all questions were answered to the parent's satisfaction.
Physical Problem List:
Physical Therapy Assessment: Child assessed using a Standardized Assessment Clinical Observations: avoids weight bearing through knees, not crawling, limited balance in standing/wobbly Parental Report: parent would like to see patient crawl and walk The patient is a 15-month-old female referred to physical therapy secondary to developmental delay. She presents with significant deficits in gross motor development, including generalized weakness, limited mobility, decreased balance, impaired coordination, atypical gait mechanics, reduced activity tolerance, and decreased kinesthetic awareness. These impairments negatively impact her ability to achieve age-appropriate developmental milestones and participate in functional activities, daily routines, and age-appropriate play. Standardized testing using the PDMS-2 indicates delayed motor performance, with stationary skills at a 10-month age equivalence and locomotion skills at a 7-month age equivalence. These findings place the patient below average for her age and reflect moderate to severe delays in both simple and more complex gross motor tasks, significantly affecting her overall developmental progression. Given the extent of these deficits, the patient demonstrates limitations in functional mobility and independence compared to age-matched peers, placing her at risk for further developmental delays and long-term functional impairments if not addressed. Skilled physical therapy services are medically necessary at this time to address identified impairments, promote strength, improve flexibility and active range of motion, enhance balance and coordination, and facilitate development of age-appropriate gross motor skills. Intervention will focus on promoting functional mobility and supporting the patient in achieving her highest level of independence and participation in daily activities, thereby optimizing overall developmental outcomes and quality of life. Patient would greatly benefit from skilled PT interventions in order to address established delays and facilitate functional independence and performance. Home programming alone is not sufficient to make the needed progress, direct one to one services are required for progress to be achieved. Results of the evaluation were reported and explained to parent(s), along w/ the diagnosis, prognosis, including the frequency, time and duration of treatment and contents of the plan of care. Family will be provided w/ a verbal report of progress noted along w/ any homework for the family as part of a home program (if applicable) at the end of every session. Parent(s) verbalized understanding of treatment plan and agreed to the initiation of skilled therapy. Goals: In 3 months, patient will pull to stand independently at various support surfaces using smooth, coordinated movement in 3 out of 4 opportunities, to promote lower extremity strength, motor planning, and progression toward pre-gait skills. In 3 months, patient will transition from short sitting to standing independently from a variety of surfaces in 3 out of 4 trials, to improve balance, spatial awareness, and functional mobility during age-appropriate transitions. In 3 months, patient will tolerate modified prone/kneeling position for 5+ consecutive minutes, 3 times per day over a 1-week period (per caregiver report), to enhance postural strength, kinesthetic awareness, and engagement in functional play. In 6 months, patient will demonstrate independent standing balance without support for at least 10 seconds in 2 or more daily opportunities over a 1-week period, to promote static balance and participation in functional play activities. In 6 months, patient will crawl forward in quadruped position independently across 10+ feet, in 2 out of 3 trials, to facilitate functional mobility, coordination, and overall strength. In 6 months, patient will ambulate independently across 25+ feet, in 3 out of 4 trials, without loss of balance, to promote age-appropriate gait, dynamic balance, and independent functional mobility.
Physical Therapy Recommendations: Physical Therapy: 1 time(s) a Week for 45 to 60 minute sessions

Physical Therapy Plan of Care:

IDPlan of Care
222
Plan Date: 03-26-2026
Physical Assessment Summary: Self Care/ADLs: Types of Food: Good appetite; eating table foods; breast fed Sleep Pattern/Cycle: Sleeps through the night in crib Mobility & Transition: Locomotion: Not pulling to stand, not crawling, walks HHA 2 handed Complicating/Personal Factors Affecting the Plan of Care: Mechanism of injury/ Illness: During check up - doctor talked to mom about therapy Multiple Treatment Areas: Weakness, decreased balance, limited mobility Patient age: 15 months Rehab Potential: Good Time since onset of injury/illness: About 4 months ago Medical History Review: High Complexity: The patient has a history of present problem with a history of 3 or more factors and/or comorbidities that impact the plan of care. Assessment: Child assessed using a Standardized Assessment Clinical Observations: avoids weight bearing through knees, not crawling, limited balance in standing/wobbly Parental Report: parent would like to see patient crawl and walk The patient is a 15-month-old female referred to physical therapy secondary to developmental delay. She presents with significant deficits in gross motor development, including generalized weakness, limited mobility, decreased balance, impaired coordination, atypical gait mechanics, reduced activity tolerance, and decreased kinesthetic awareness. These impairments negatively impact her ability to achieve age-appropriate developmental milestones and participate in functional activities, daily routines, and age-appropriate play. Standardized testing using the PDMS-2 indicates delayed motor performance, with stationary skills at a 10-month age equivalence and locomotion skills at a 7-month age equivalence. These findings place the patient below average for her age and reflect moderate to severe delays in both simple and more complex gross motor tasks, significantly affecting her overall developmental progression. Given the extent of these deficits, the patient demonstrates limitations in functional mobility and independence compared to age-matched peers, placing her at risk for further developmental delays and long-term functional impairments if not addressed. Skilled physical therapy services are medically necessary at this time to address identified impairments, promote strength, improve flexibility and active range of motion, enhance balance and coordination, and facilitate development of age-appropriate gross motor skills. Intervention will focus on promoting functional mobility and supporting the patient in achieving her highest level of independence and participation in daily activities, thereby optimizing overall developmental outcomes and quality of life. Patient would greatly benefit from skilled PT interventions in order to address established delays and facilitate functional independence and performance. Home programming alone is not sufficient to make the needed progress, direct one to one services are required for progress to be achieved. Results of the evaluation were reported and explained to parent(s), along w/ the diagnosis, prognosis, including the frequency, time and duration of treatment and contents of the plan of care. Family will be provided w/ a verbal report of progress noted along w/ any homework for the family as part of a home program (if applicable) at the end of every session. Parent(s) verbalized understanding of treatment plan and agreed to the initiation of skilled therapy.
Physical Rehabilitation Potential: Good. with consistent Physical Therapy and parental support
Physical Treatment Plan:
Physical Long Term Goals:
CategoryGoal Description
In 6 months, patient will demonstrate independent standing balance without support for at least 10 seconds in 2 or more daily opportunities over a 1-week period, to promote static balance and participation in functional play activities.
In 6 months, patient will crawl forward in quadruped position independently across 10+ feet, in 2 out of 3 trials, to facilitate functional mobility, coordination, and overall strength.
In 6 months, patient will ambulate independently across 25+ feet, in 3 out of 4 trials, without loss of balance, to promote age-appropriate gait, dynamic balance, and independent functional mobility.
Physical Short Term Goals:
CategoryGoal Description
In 3 months, patient will tolerate modified prone/kneeling position for 5+ consecutive minutes, 3 times per day over a 1-week period (per caregiver report), to enhance postural strength, kinesthetic awareness, and engagement in functional play.
In 3 months, patient will transition from short sitting to standing independently from a variety of surfaces in 3 out of 4 trials, to improve balance, spatial awareness, and functional mobility during age-appropriate transitions.
In 3 months, patient will pull to stand independently at various support surfaces using smooth, coordinated movement in 3 out of 4 opportunities, to promote lower extremity strength, motor planning, and progression toward pre-gait skills.

Completed Appointments:

Appt-IDServiceStart-DateEnd-DateTherapistLocationStatus
91035297163: PT Evaluation03-26-2026 08:00 AM03-26-2026 09:00 AMDolly MolinaNB1 east sideCompleted

Paient Messages Admin:

DatePosted ByMessage
03-18-2026 01:18 PMJulie MoraPlease fillout the form https://patient.newbeginnings-elp.com/Registration/default.aspx?sid=2743
03-18-2026 02:01 PMShekinah VelasquezSchedule Evaluation: When you are ready to schedule your evaluation, click this link https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=10036
03-19-2026 08:36 AMShekinah VelasquezSchedule Evaluation: Are you having problems scheduling your Physical Therapy Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=10036
03-23-2026 11:31 AMShekinah VelasquezHello Tricare Families,

We would like to inform you of an important update regarding therapy services. Due to a recent change in Tricare’s process, all patients are now required to be seen by their Primary Care Provider (PCP/PCM) and have an updated referral submitted to Tricare before we can request authorization for therapy.

Please note:
-The referral end date provided by your PCP/PCM will determine the authorization period for therapy services.
-If possible, we recommend requesting a referral period of up to one year, as this will help reduce the number of required follow-up visits.
-If you are unsure whether a current referral is on file, please contact your PCP/PCM or Tricare Referral Management directly.

This change began earlier this month. While we are actively reviewing all existing referrals, we kindly ask for your assistance in scheduling an appointment with your PCP/PCM and ensuring an updated referral is submitted to help avoid any delays in therapy services.

If you are able to view your referral end date, please be aware that your child will need to be seen again before that date to continue services.

We appreciate your patience and cooperation during this transition. If you have any questions, please don’t hesitate to contact our office.

Thank you for your time and support.

Paient Messages Therapist:

DatePosted ByMessage
03-19-2026 02:05 PMDolly MolinaGood afternoon,
My name is Dolly Molina, and I am the physical therapist at New Beginnings. I am reaching out to schedule a Physical Therapy Evaluation appointment with you. I am available on March 20, 2026 at 10:00 AM, and I hope this time works for you.
Please let me know if you are available at that time or if we need to find an alternative appointment.
Thank you,

Dolly Molina PT MPT

Physical Therapist

New Beginnings
03-19-2026 02:06 PMJosephine GagliardoJosephine (Prim) Replied: Hello. We are out of town until Monday for spring break. I apologize!
03-19-2026 02:06 PMDolly MolinaHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-19-2026 02:07 PMDolly MolinaOh no worries. That is Ok. I can set something up for next week. Will that work for you?
03-19-2026 02:07 PMJosephine GagliardoJosephine (Prim) Replied: Certainly. I do work during the week. What day/time are you available?
03-19-2026 02:07 PMDolly MolinaHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-19-2026 02:09 PMDolly MolinaI have 3/26/26 at 8:00 am available
03-19-2026 02:10 PMJosephine GagliardoJosephine (Prim) Replied: That won't work either. I'm sorry! Is it possible to be seen on a Monday? Or Thursday or Friday after 4 pm?
03-19-2026 02:10 PMDolly MolinaHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-19-2026 02:17 PMJosephine GagliardoJosephine (Prim) Replied: How long will the appointment be? 1 hour?
03-19-2026 02:17 PMDolly MolinaHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-19-2026 02:17 PMDolly MolinaMy availability at New Beginnings is currently limited to Tuesdays and Thursday mornings due to my schedule at other facilities. After the initial PT evaluation is completed, future appointments can be scheduled with our full-time PT team, which will allow for greater flexibility and later appointment times.
03-19-2026 02:18 PMDolly MolinaYes the PT evaluation takes 1 hour
03-19-2026 02:18 PMJosephine GagliardoJosephine (Prim) Replied: Let's schedule the 3/26 at 8 am. I will arrange my work schedule accordingly. What is the address for this location? We are typically seen at the Rich Beem location.
03-19-2026 02:18 PMDolly MolinaHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-19-2026 02:24 PMDolly MolinaThank you for your flexibility in adjusting your schedule to complete this PT evaluation. the PT office is at 1510 Zaragosa Building B-1. When you enter the drive way to the business offices you will continue on the path until it almost dead ends - then you will see signage that says Building B. You will turn to the right. If you go left you will enter parking lot for the main New Beginnings office. The PT building is at the end of a long row of office spaces. Continue to the end of the row just past a window tint shop.
03-19-2026 02:25 PMDolly MolinaI have your appointment set on my calendar. Thank you and I look forward to meeting you both.
03-19-2026 02:25 PMJosephine GagliardoJosephine (Prim) Replied: Thank you!
03-19-2026 02:25 PMDolly MolinaHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-19-2026 02:30 PMDolly MolinaMy pleasure
03-25-2026 06:30 PMDolly MolinaHi, this is a just a reminder that Josephine has a Physical Therapy Evaluation appointment scheduled tomorrow at 08:00 AM. See you soon! - New Beginnings 🙂
03-26-2026 07:45 AMDolly MolinaJosephine Gagliardo : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=910352
03-26-2026 07:45 AMJosephine GagliardoJosephine is RUNNING LATE for:
8:00AM-3/26/2026
97163: PT Evaluation
03-26-2026 07:57 AMDolly MolinaHi, this is a just a reminder that Josephine has a Physical Therapy Evaluation appointment scheduled today at 08:00 AM. See you soon! - New Beginnings 🙂
03-26-2026 07:57 AMJosephine GagliardoJosephine (Prim) Replied: Thank you! We are on our way. Traffic is heavy. Our ETA is 8:07
03-26-2026 07:57 AMDolly MolinaHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-26-2026 08:00 AMDolly MolinaBe careful. I am here.
03-26-2026 08:02 AMDolly Molina1510 Zaragosa Building B-1. It is in opposite direction of main office.
03-26-2026 08:03 AMDolly MolinaUpon entering the driveway to the business offices behind Ernie’s Cafe Restaurant, continue straight ahead until the road nearly dead ends. Look for the rock sign stating Building B. You will turn RIGHT. Turning left will take you to the main New Beginnings office parking lot. The physical therapy office is located to the RIGHT on the corner at the very end of the row of Building B offices, just past the window tint shop.
03-26-2026 08:06 AMJosephine GagliardoJosephine (Prim) Replied: I think we are here!
03-26-2026 08:06 AMDolly MolinaHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-26-2026 02:48 PMMatthew MartinezHello Josephine, this is Matthew — I’m part of the full-time PT team here at New Beginnings. Dolly shared that a twice-per-week schedule would be most beneficial for you and that Fridays tend to work best. I currently have openings next Friday (04/03) at 10:00 AM or 11:00 AM. Please let me know if either time works well for you — Matt
03-26-2026 02:56 PMJosephine GagliardoJosephine (Prim) Replied: Hi there! Mondays actually work best for me. I apologize for the confusion!
03-26-2026 02:56 PMJosephine GagliardoJosephine (Prim) Replied: She had almost mentioned that once per week is what was being recommended. Has this changed?
03-26-2026 03:16 PMMatthew MartinezMy apologies, lets stick with what Dolly recommended. Sorry for the confusion. Let me know if there is anything I can do to help.

Best,
Matt