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The rating scale for Family A is 10/15 according to the Omaha System Problem Rating Scale for Outcomes(Stanhope & Lancaster, 2018, p.591). Information was obtained during the first visit/encounter to complete the above table. Moreover, Family A is a nuclear family that consists of two parents and four children under the age of 25 years old. Currently the family lives in a densely populated area, with high rates of crime and violence, with air and noise pollution, nearby environmental hazards, and where access to fresh food and parks and outdoors areas is limited. Family A also lives in a small house compared to their needs, siblings must share one room and the furniture (including mattresses) is old and damaged which might lead to disease like asthma. In addition, family A is a first-generation immigrant, parents are not fluent in English. Family A only visits the doctors when urgently needed. They rely on food stamps, their diet is based on fried food, and they currently cannot afford fresh healthy food in addition to their cultural beliefs. Family A is not aware of the various diseases they are exposed to due to their environment, their cultural background and habits to food, and their neglect to primary care visits and preventative screenings, in addition family As socioeconomic status and English barrier makes it difficult to have access to fresh food and a healthy diet as well as not enough recreational areas for exercise. Their immigration status may also lead to alienation and isolation and many psychological issues.