Purpose: Social determinants of health (SDOH) are widely accepted risk factors of health disparities. Addressing SDOH may reduce the risk of poor health outcomes. Desiring to provide comprehensive preventative care, we developed and piloted a screening tool for use in our resident primary care, safety net clinic to identify social needs most affecting our pediatric patients. Methods: A multidisciplinary team of clinical social workers and physicians from the emergency department, internal medicine, and pediatrics selected broad categories of SDOH relevant to our patient population: childcare, neighborhood safety, community relationships, transportation access, housing security, food security, violence exposure, child abuse risk, and substance abuse. Validated screening questions for two age groups—birth to 12 years and 13 to 21 yeas-- were identified via literature review. Questions were assessed and selected based on evidence strength, reading level, geographic and age relevance, and broad interpretability. Two screens of ten and nine questions to be filled out by parents or adolescents, respectively, were created in English and Spanish. Workflows were developed with the help of clinical social workers outlining steps for referral, consults, and patient education in the event of a positive screen. When rooming a patient, the nursing staff introduced and provided the appropriate screen based on patient age and language preference. Providers reviewed screen answers while with the families and confirmed desire for assistance before acting on an identified need. Results: In the first three months of the pilot, 126 screens were completed—97 by parents and 29 by adolescents. About 79% of parental and 96% of adolescent screens were positive (indicated one or more need), identifying a total of 145 needs. In descending order, top parental needs were childcare resources, housing security, and child abuse prevention; top adolescent needs were community activities, housing security, and transportation access tied with food security. Two screens identified domestic violence in well-established clinic families for whom there was no prior suspicion. Since implementation, social work referrals for emergent crisis intervention have decreased and referrals to social work for preventative resource assistance has increased with social work follow-up times all within 24 hours, decreased from previous follow-up times of one to two weeks. Based on preliminary survey data, clinic cycle times have also decreased from an average of 50 minutes to 35.5 minutes. Conclusion: Although in its pilot phase, the screening tool has proven effective in identifying patient SDOH needs within our clinic. We plan to broaden the screen’s use into all of our campus’ pediatric primary care clinics, and similar tools in the medicine and emergency medicine departments. We have also gained enough data to pilot a departmental community health worker, who can help coordinate referrals and follow-up for patients and families with identified needs.