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© KAFF HOMECARE INC. DEVELOPED BY KAFF HOMECARE INC IT

ONLINE POLICY DOCUMENTATION


Every In Home Service Worker who works at KAFF HOMECARE INC. is given a Job Description. This is subject to change at any time for any reason with or without notice or cause.

I have read the above statement regarding the job description and understand the meaning.

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Description:

  • Homemakers provide service to individuals in their homes and communities, who need assistance caring for themselves as a result of old age, disability and/or other inflictions. Home care may include house cleaning, laundry, meal preparation transportation, companionship and respite.
  • Homemakers are responsible for ensuring that service is delivered in a caring and respectful manner, in accordance with relevant Agency policies and industry standards.

Reporting Relationship

  • Reports to Supervisor.

Responsibilities/Activities:

  • Teach/perform meal planning and preparation, routine housekeeping activities such as making/changing beds, dusting, vacuuming, washing floors, cleaning kitchen and bathroom, and laundry,
  • Perform/assist with essential shopping/errands, which may include handling the clients money, in accordance with the care plan and under the observation of the Supervisor.
  • Assist with following a written, special diet plan and reinforcement of diet maintenance, which is provided under the direction of a Physician and as identified in the care plan.
  • Escort to medical facilities, errands, shopping and outings as specified In the care plan.
  • Provide companionship, friendship and emotional support.
  • Assist clients with communication by writing or typing correspondence for them or researching information for them.
  • Participate on the Care Team by providing Input and making suggestions.
  • Ensure service is delivered in accordance with all relevant policies, procedures and practices.
  • Monitor supplies and resources.
  • Evaluate the program and make recommendations to it, as indicated.
  • Follow the written care plan.
  • Carry out duties as assigned by the Supervisor.
  • Observe the client's functioning and report to Supervisor,
  • Complete and maintain records of daily activities, observations, and direct hours of service.
  • Attend orientation, in-service training sessions and staff meetings.
  • Develop and maintain constructive and cooperative working relationships with others.
  • Make decisions and solve problems.
  • Communicate with Supervisor and co-workers.
  • Observe, receive and obtain information from relevant sources.

Required Knowledge

  • Knowledge of home management skills.
  • Knowledge of principles and processes for providing client and personal services, including needs determinants, meeting quality standards and evaluation of client satisfaction.
  • Knowledge of the English language.
  • Knowledge of information and techniques needed to diagnose and treat injuries including emergency first aid and CPR.
  • Knowledge of clerical procedures such as maintaining records and completing forms.

Required Skills/Abilities:

  • The ability to be aware of other people's reactions and understand why they react as they do.
  • The ability to establishing and maintain relationships.
  • The ability to teach others.
  • The ability to apply reason and logic to identify strengths and weaknesses of possible solutions.
  • The ability to Identify problems and determine effective solutions.
  • The ability to understand written and oral Instructions.
  • The ability to communicate information orally so others understand.
  • The ability to communicate in writing so others understand.
  • The ability to listen and understand the spoken word.
  • The ability to work independently and in cooperation with others.
  • The ability to determine or recognize when something is likely to go wrong.
  • The ability to suggest a number of ideas on a subject.
  • The ability to perform activities that use the whole body.
  • The ability to handle and move objects and people.
  • The ability to provide advice and consultation to others
  • The ability to observe and recognize changes in clients.
  • The ability to establish and maintain harmonious relations with clients/families/co-workers.

 Physical and Mental Demands:

  • Good physical and mental health,
  • Physical ability to stand, walk, use hands and fingers, reach, stoop, kneel, crouch, talk, hear and see.
  • Mental fortitude and stability to handle stress.
  • Physical and mental ability to drive a vehicle.

Qualifications/Education:

  • High school diploma
  • Current driver's license.
  • Proper Vehicle Insurance Coverage.

Training/Experience:

  • May require related experience.

 

I have read and understand the Job description and agree to fulfill the position's responsibilities.

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Every employee who works for KAFF HOMECARE INC, is hired in an employment-at-will status. Employment-at-will means that employees who are employed at the will of KAFF HOMECARE INC are subjected to termination at any time for any reason, with or without notice or cause. Subsequently, an employee may not terminate employment with KAFF HOMECARE at any time without early notification (at least 1 week)

I have read the above statement regarding employment- at-will and understand the meaning of this type of employment.

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I have read and understand and agree to abide by KAFF HOMECARE, INC drug-free workplace policy.

I understand that during the course of my employment, I may be asked to provide a urine specimen or blood sample for testing to determine if I have used alcohol or drugs. I UNDERSTAND THAT I DO NOT HAVE TO PROVIDE SUCH SPECIMEN OR SAMPLE IF I CHOOSE NOT TO DO SO, BUT THAT MY REFUSAL MAY RESULT IN MY IMMEDIATE DISCHARGE OR OTHER DISCIPLINARY ACTION AGAINST ME.

If I decide to provide a urine specimen or blood sample for drug or alcohol testing, I hereby give consent to and authorize KAFF HOMECARE INC, and all companies related to KAFF HOMECARE INC, and its Director, Officers, In Home Service Workers, agents, representatives, Parent company, subsidiary or related companies to use a specimen or sample in any manner it deems appropriate including but not limited to releasing such specimen or sample to a testing laboratory or other person or service for testing. I hereby release the company from any and all claims or liability arising out of or relating to the enforcement of its Drug-free Workplace Policy.

In the event of a work-related accident, injury or company vehicle accident, I understand that KAFF HOMECARE INC, has the right to require me to submit to an alcohol / drug test, and that refusal on my part to take such a test within 24 hours of the accident or injury or company vehicle accident will result in disciplinary action up to and including discharge.

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I understand and agree that as an employee of KAFF HOMECARE INC, there are no guaranteed hours or visit and I am considered a temporary employee. It is my responsibility to contact KAFF HOMECARE INC, after each completed assignment to update my schedule and availability.

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Illinois unemployment law requires an in home service worker to seek additional work from his/her Employer upon the completion of an assignment.

Failure to seek subsequent work upon completion of an assignment will be considered a voluntary quit or not available for work and could result in denial of unemployment benefits.

I have read and understand the above

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CHILD ABUSE:

SECTION 11166 OF THE PANEL CODE REQUIRES THAT THE CHILD CARE CUSTODIAN, HEALTH PRACTITIONER, OR IN HOME SERVICE WORKER OF A CHILD PROTECTIVE AGENCY WHO HAS KNOWLEDGE OF/OBSERVE A CHILD (IN HIS/HER PROFESSIONAL CAPACITY OR WITHIN THE SCOPE OF HIS/HER EMPLOYMENT) WHOM HE/SHE KNOWS OR REASONABLY SUSPECTS HAD BEEN THE VICTIM OF CHILD ABUSE MUST REPORT THE KNOWN OR SUSPECTED INSTANCE OF CHILD ABUSE TO A CHILD PROTECTIVE AGENCY IMMEDIATELY OR AS SOON AS PRACTICALLY POSSIBLE BY TELEPHONE AND TO PREPARE AND SEND A WRITTEN 36(THIRTY SIX) HOURS OF RECEIVING THE INFORMATION ABOUT THE INCIDENT.

ELDER AND DEPENDENT ADULT ABUSE:

SECTION 15630 OF THE WELFARE AND INSTITUTIONS CODE REQUIRES THAT CARE CUSTODIANS, HEALTH PRACTITIONERS, IN HOME SERVICE WORKERS OF ADULT PROTECTIVE SERIES AGENCIES, OR LOCAL LAW ENFORCEMENT AGENCIES WHO ( IN THEIR PROFESSIONAL CAPACITY OR WITHIN THE SCOPE OF THEIR EMPLOYEMENT) OBSERVE EVIDENCE OF OR HAVE BEEN TOLD BY AN ELDERLY OR DEPENDENT ADULT THAT HE OR SHE IS A VICTIM OF PHYSICAL ABUSE MUST REPORT THIS TO COUNTY ADULT PROTECTIVE SERVICES OR A LOCAL LAW ENFORCEMENT AGENCY IMMEDIATELY, OR AS SOON AS POSSIBLE, BY TELEPHONE WITH A WRITTEN REPORT SUBMITTED WITHIN TWO WORKING DAYS, FOR PERSONS IN LONG TERM CARE FACILITIES, THE OBSERVED PHYSICAL ABUSE OR CLIENT DESCRIBE ABUSE SHOULD BE REPORTED TO THE LONGTERM CARE OMBUDSMAN COORDINATOR OR LOCAL LAW ENFORCEMENT AGENCY. STATE LAW PERMITS REPORTING OF OTHER TYPES OF ABUSE SUCH AS NEGLECT, INTIMIDATION, FIDUCIARY ABUSE, ABANDONMENT, ISOLATION, OR OTHER TREATMENT THAT RESULT IN PHYSICAL HARM, PAIN, OR MENTAL SUFFERING WHEN THE REPORTER HAS KNOWLEDGE OF OR REASONABLY SUSPECTS ONE OR MORE OF THESE TYPES OF ABUSE HAVE OCCURRED. ELDERS ARE DEFINED AS PERSONS 65YEARS OR OLDER AND DEPENDENT ADULTS ARE DEFINED AS PERSONS BETWEEN THE AGES OF 18 AND 64 WHOSE PHYSICAL LIMITATION RESTRICT THEIR ABILITY TO CARE FOR THEMSELVES.

GENERAL ABUSE:

SECTION 11160 OF THE PANEL CODE REQUIRES HEALTH PRACTITIONERS WHO IN THEIR PROFESSIONAL CAPACITY OF WITHIN THEIR SCOPE OF EMPLOYMENT PROVIDE MADICAL SERVICES FOR A PHYSICAL CONDITION TO A PATIENT WHOM THEY KNOW OR REASONABLY SUSPECT HAS AN INJURY THAT IS THE RESULT OF ASSAULT OR ABUSIVE CONDUCT TO REPORT THIS TO A LOCAL LAW ENFORCEMENT AGENCIES DUE WITHIN TWO WORKING DAYS, THIS STATUTE IS EXTREMELY BROAD. IT INCLUDES ADULTS, CHILDREN AND OTHER PERSONS (INCLUDING SPOUSES).

"HEALTH PRACTITIONERS" INCLUDES PHYSICIANS AND SURGEONS, PSYCHIATRISTS, PSYCHOLOGISTS, DENTISTS, RESIDENTS, INTERNS, PODIATRISTS, CHIROPRACTORS,

LICENSED NURSES, DENTAL HYGIENISTS, OPTOMETRISTS, OR PROFESSIONS CODE, AS WELL AS ADDITIONAL PRACTITIONERS AS DEFINED IN SECTION 11166 OF THE PANEL CODE OR SECTION 15632 OF THE WELFARE AND INSTITUTIONS CODE.

FAILURE TO COMPLY WITH THESE LAWS IS A MISDEMEANOR, PUNISHABLE BY UP TO SIX MONTHS IN JAIL OR BY A FINE OF ONE THOUSAND DOLLARS ($1,000.00) OR BOTH, AS WELL AS UNPROFESSIONAL CONDUCT AND CAN RESULT IN DISICIPLINARY ACTION AGAINST THE RN'S LICENSE.

I CERTIFY THAT 1 HAVE READ AND UNDERSTAND THIS STATEMENT AND WILL COMPLY WITH MY OBLIGATIONS UNDER THE CHILD ABUSE/NEGLECT REPORTING LAW.

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STANDARDS OF CONDUCT

  1. The customers/clients home is "your place of business"; you must conduct yourself appropriately as you are at work.
  1. You must NOT take friends, children or family to work.
  2. Call ahead and advise the customer when you are running late.
  1. Personnel are expected to complete daily assignments as scheduled or assigned by the supervisor. If an emergency arises, personnel are to notify their immediate supervisor as soon as possible during the workday.
  1. Notice of absence must be given not later than 4 hours before your  scheduled start time.
  2. . Notice of absence must only (NOT SMS, INSTAGRAM OR OTHER SOCIAL MEDIA).
  1. Personnel are not to leave the field or their work area without completing the scheduled visits/shifts for that day or their work assignments for that day.
  1. The customer/client may allow you to leave, but you MUST NOT leave yourself.
  2.  You should call your supervisor in advance when you cannot complete your scheduled assignment.
  1. All paperwork is to be completed in a timely, accurate manner. Any falsification of documentation results to disciplinary action, including termination,
  1.  Falsification of timesheets is FRAUD.      
  2. Attendance records must be accurate.
  3. Signing into CARE WHEN the check-in system is mandatory.
  1. An employee CANNOT work for, be hired through another agency or work directly with the customer or patient with whom they are assigned, until after a period of 3 months of leaving KAFF HOMECARE INC, as an employee.
  1. Any fees for service, salaries and/or contract fees earned in violation will be owed to TCP immediately.
  2. You MUST NOT solicit the customer to otherwise hire your services in any way, shape or form.
  1. Employees are STRICTLY PROHIBITED FROM DRIVING THE CUSTOMER IN THE EMPLOYEE'S OWN VEHICLE, while on duty.
  1.  Employees may run errands for the customer, in the employees own vehicle within a reasonable distance (grocery, post office, pharmacy etc.)
  2.  Employees may accompany customers in their (customers) own vehicle or in commercial transport.
  1. Personnel must not allow private interests to conflict with those of their patients.
  1. Your personal business MUST remain personal. DO NOT discuss your affairs with the customer.
  2. You are not permitted to ask for, accept a loan or gift of  money or object of material value from patients, their  families, or caregivers.
  3. Payroll and Administrative issues with TCP Is your business. Do not discuss with the customer.
  1. Failure to adhere to any of the following or falsification of any employment records as well as documentation within the course of the workday will result in disciplinary action, which may include termination of employment and possible prosecution with IDPH.
  1.  Refusal or deliberate failure to carry out instructions given by supervisor.
  2. Fighting or creating a disturbance on organization premises or in a patient's home.
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KAFF HOMECARE INC, will not tolerate conduct by any employee/client who harasses, disrupts, or interferes with another's work or creates an offensive or hostile work environment. While all forms of harassment are prohibited, KAFF HOMECARE INC, emphasizes that sexual harassment is specially prohibited.

PURPOSE

To ensure an effective means by which an employee who believes that he/she has been subjected to sexual harassment in the workplace can report the incident.

SPECIAL INSTRUCTIONS

Any employee who believes that he/she has been subjected to sexual harassment in the workplace, by a manager, co-worker, or client, should report the incident to the President ( ) as soon as possible, If the employee feels uncomfortable discussing the incident with the Vice president or the incident relates to or involves the Vice, the Homecare/Home Service Head of Department( ) shall be notified.

Any employee who violates the policy against sexual harassment, or encourages another to violate the policy, will be subject to appropriate disciplinary action, depending on the severity and type of violating behavior, up to and including discharge. The following behavior is considered a violation to this policy:

  1. Threatening or insinuating that an applicant or employee should submit to sexual advances or that refusal to submit to sexual advances will adversely affect employment, including evaluation, wages, promotional opportunities, or assignments.
  2. Giving favorable treatment in any way to an applicant or employee because that person has shown a willingness to perform sexual activities.
  3. Making unwelcome or unwanted sexual activities. This Includes patting, pinching, brushing up against, hugging, cornering, kissing, fondling, or any other similar physical contact considering unacceptable by another individual.
  4. Verbally abusing or kidding that is sex-oriented and considered unacceptable by another individual.

            This includes :

  • Comments about an individual's body or appearance (where such comments go beyond a mere compliment).
  • Off-color Jokes that are clearly unwanted or considered offensive by others.
  • Any other tasteless, sex-oriented comments, innuendoes, or offensive actions.

5. Displaying sexually suggestive objects or pictures, including nude photographs, in the workplace.

6. Any other sexually oriented conduct that would seriously interfere with another's work performance.

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KAFF HOMECARE INC, personnel must read and sign their acknowledgement of the following statement:

By accepting employment with KAFF HOMECARE INC, you have obligated yourself to carefully refrain from discussing any client's condition or personal affair with anyone outside the agency, unless you have been instructed to do so. Do not pass on medical information to clients and/or visitors unless you have been instructed to do so by your supervisor.

All information seen or heard regarding clients directly or indirectly, is completely confidential and is not to be discussed even with your family. Your job as an employee requires that you govern yourself by high ethical and professional standards, the absence of which could involve and employee in legal proceedings.

Information about clients or the agency is not to be given to the media. This is essential for protection of both the client and KAFF HOMECARE INC, Agencies are bound by very strict laws and requirements regarding the release of information concerning clients

I have read and understand the above statements.

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ADDENDUM TO EMPLOYMENT AGREEMENT

As a consideration and as a condition precedent to continued employment with KAFF HOMECARE INC, ("KAFF"), the undersigned, hereinafter referred to as "Employee" agrees to be bound as follows:

COVENANT OF NONCOMPETITION

At all times during the Employee's employment and for one ( 1 ) year after termination of employment with KAFF, Employee agrees not to directly or Indirectly, in one or a series of transactions, own, manage, operate, control, invest or acquire an interest in, or otherwise engage or participate in the business of, whatever as a proprietor, partner, director, officer, Joint venture, Investor, lessor, representative, lender, guarantor, or other participant for, any business, individual or entity engaged in providing of home health care/home care or any other services for which KAFF provides, including any entity employing personal in any similarity situated position as that held by the Employee with KAFF within fifty (50) miles of any Corporate or Branch Office of KAFF.

COVENANT OF DISCLOSURE

Employee agrees that to the extent that he or she, directly or indirectly, including through any relationship with the employees spouse, parent or children, In one or a serious of transactions, owns, manages, operates, controls, Invests or acquires any Interest In, or otherwise engages or participate in the business of, whether as a proprietor, partner, director, officer, employee, Joint venture, independent contractor, consultant, Investor, lessor, agent, representative, lender, guarantor, or other participant in ( collectively referred to as relationship ) any business, Individual or entity engaged In the providing of home health care/home care or any other services for which KAFF provides, Including any entity employing personnel in any similarity situated position as that held by the Employee with the KAFF, agrees to disclose the relationship, within five (5) business days to disclose to the Officers of KAFF. Disclosure of such relationship does not waive any right of KAFF.

COVENANT OF NONSOLICITATION

At all times during the Employee's employment and for one (1) year after termination of employment with KAFF, Employee agrees that he or she will not engage in solicitation of KAFF's clients or patients, whether past or present clientele or patients, and further agrees to not solicit or recruit directly or indirectly, any employees of KAFF, whichever is closer, nor encourage employees in the employment of KAFF to breach the terms of their agreement with KAFF.

COVENANT OF NONDISCLOSURE

The term "confidential Information" as used in the agreement includes but is not limited to, records, lists and knowledge of KAFF's customers, suppliers, methods of operation, processes, trade secrets, methods of determination of prices, business plans, budgets, financial condition, profits, sales, net Income, and indebtedness, as the same may exist from time to time in any form, media or format, Employee agrees that he or she shall not, at any time form and after the date hereof, In any manner, either directly or indirectly, divulge, disclose, or communicate to any person, firm, corporation, or other entity, or use for his or her own benefit or for the benefit of any person, firm, corporation, or entity and not for the benefit of KAFF, any confidential information of KAFF, without the express prior written consent of an authorized officer of KAFF.

The Employee further agrees to disclose to the KAFF within two (2) business days the existence of all KAFF data, in any form, that is Stored on his or her personal computer or other equipment including cellular phones, personal data assistance, USB drives, CD/DVD or other medium Following disclosure, upon request of the KAFF, the employee agrees to Immediately irrevocably destroy by the KAFF.

COVENANT OF NONDISPARAGEMENT

At all times during the employee's employment and after termination of employment with KAFF, employee further agrees that he/she shall not, at any time, make, directly or indirectly. Any oral or written public statements that are disparaging of, or are intended to disparage, discredit or injure KAFF, any products or services KAFF offers, or any of its shareholders , partners, affiliates, successors, assigns, including any of its present or former officers, directors, partners, agents or employees.

The employee further agrees that he/she will not make any statements or engage in any conduct, that would (in any manner harm KAFF or its shareholders, board of directors, officers, employees or other assigns reputation, relationships and goodwill with its customers, suppliers, employees or others having business dealings with KAFF during Employee's employment and after termination of employment with KAFF.

USE OF KAFF HOMECARE EQUIPMENT/PROPERTY

The Employee agrees to not, directly or indirectly, copy, take, or remove from KAFF premise(s), any of KAFF's books, records, customer list, or any other documents, data, or materials. The Employee understands that all equipment issued for use by (its employees, either directly or indirectly, is and irrevocably remains that sole and exclusive property of KAFF. The Employee agrees to not use personal computer, electronic equipment or media including US drives, CD/DVDs or hard drives in conjunction with KAFF equipment. Employee agrees not to install any unauthorized computer programs upon KAFF computers, and agrees not to use KAFF equipment to surf, download, navigate or peruse the internet for any personal purpose, without express permission of KAFF. As a condition of employment, upon termination of employment, the Employee agrees to return all equipment and property of the KAFF, including but not limited to computer equipment, cellular phones, global positioning systems, books, records, customer lists or any other document or material to the KAFF with1n two (2) business days of termination of employment, The Employee also agrees to be liable to the KAFF for any equipment and property that is not returned to the KAFF.

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I, the undersigned, understand the importance of observing strict confidentiality policies. Therefore, I agree not to discuss/release any information obtained within the agency regarding any KAFF HOMECARE  INC,( KAFF ) client, their medical record, or any client's condition with any individual not directly associated with KAFF nor with KAFF employees who are not directly associated with that client. I also agree that any information that is released regarding the client or the client's record will only be done with proper authorization and/or in accordance with established agency policy for the release of the information.

My signature on this document indicates that I understand and agree to abide by the aforementioned policies and that any breach in the aforementioned policies will result in implementation of the Disciplinary procedure up to and including possible IMMEDIATE DISMISSAL from employment at KAFF.

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If I have questions regarding the content or interpretation of this Employee Handbook, I will ask the superior or a member of management.

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As an employee of KAFF HOMECARE INC, I understand that it is our policy that we do not provide transportation for any of our clients, if I take upon myself to take a client of KAFF HOMECARE INC in my vehicle or drive a client's vehicle, I take full responsibility for any claim, demand, action or causes of action for damages, cost, loss of services, expenses, or compensation for on account of, or hereafter grow out of any accident which may happen as a result of the transportation I provide.

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If a participant is involved in a vehicle accident during in-home service, KAFF HOMECARE INC, employees must follow the following procedure.

  1. Call 911.
  2. Follow the directions of the emergency responders.
  3. If safe to do so, remain at the scene with the participant.
  4. Contact the provider office and notify the Supervisor of the accident.
  1. The Supervisor will contact participant's family member or emergency contact.
  1. Complete detailed documentation of the event in the participant's file.
  2. Complete report in IDOA Critical Event System.

 

STATE OF ILLINOIS DEPARTMENT ON AGING

As an employee of an entity doing business with the Community Care Program (CCP), you represent the public face of your employer and the Illinois Department on Aging. It is your responsibility to provide service in a professional and ethical manner to the older adults who receive services as participants in this program.

I  have reviewed the Limitations on Marketing and Recruiting

Activities Under the Community Care Program Policy/Power Point and acknowledge my understanding of and responsibility to comply with the following non-exhaustive list of requirements under the CCP as set forth by federal and State laws, the 1915(c) Medicaid Waiver for the Elderly, regulations/rules, policies/procedures, the provider service certification, and the provider service agreement:

  •  An individual may choose at any time to not receive services for which eligibility has been determined under the CCP.
  • An individual has the right to select a provider of his or her choice based on availability in the service area at any time during participation in the CCP.
  • All information about an individual's case is to be kept confidential under the CCP. This Information may be used ONLY for purposes directly related to the administration of this program. This information cannot and should not be shared between provider agencies.

      *Confidential case information includes, but is not limited to the  following items:

Name, SSN, Date of Birth, Address, Medicaid Number and Status, Family/Guardian  Name(s) and Contact Information, Phone Numbers, Financial Account Numbers, and Medication(s) or other health information. 

*This information may be maintained in any form or medium (i.e., electronic, oral, or paper).

*Confidentiality continues beyond the termination of employment.

  •  The CCP prohibits the use of unsolicited telephone calls (cold-calling) and door-to-door solicitations; sales activities at community meetings, educational events and health care facilities; and cross-selling of non-CCP-related services to current and prospective program clients.
  •  Failure to comply with program requirements may subject you and/or your employer to sanctions imposed by the Department or other government officials with oversight responsibilities. Possible sanctions include, but are not limited to:

 * Participation in additional mandatory trainings.

 * Imposition of a ban on continued employment in the capacity as a caregiver under the CCP and other publicly funded programs in Illinois. 

 * Placement of name on the Adult Protective Service Registry.

ORIGINAL OF THIS ACKNOWLEDGEMENT SHOULD BE MAINTAINED IN EACH EMPLOYEE'S PERSONNEL FILE.

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My employer or home care agency, KAFF HOMECARE, INC. has recommended that I receive influenza vaccination in order to protect myself and the clients I serve.
 
 
I acknowledge that I am aware of the following facts:
 
  • Influenza is a serious respiratory disease that kills an average of 36,000 persons and hospitalizes more than 200,000 persons in the United States each year
  • Influenza vaccination is recommended for me and all other healthcare workers to prevent influenza disease and its complications, including death.
  • If I contact influenza, I will shed the virus for 24-48 hours before influenza symptoms appear. My shedding the virus can spread influenzas infections to clients.
  • If l become infected with influenza, even when my symptoms are mild, I can spread severe illness to others.
  • I understand that the strains of virus that cause influenza infection changes almost every year, which is why a different Influenza vaccine is recommended each year,
  • I cannot get the influenza disease from the influenza vaccine.
  • The consequences of my refusing to be vaccinated could endanger my health and the health of those with whom I have contact, including:
                                              * Clients
                                              * My co-workers
                                              * My family
                                              * My community
Despite these facts, I am choosing to decline influenza vaccination for right now.
 
I understand that I may change my mind at any time and accept the Influenza vaccination, if vaccine is available.
 
I have read and fully understand the information on this declination form.
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I have been informed by my employer about the:

RISKS:

  •  People over 65 are at high risk of serious Flu- related complications because the Immune system weakens with age.
  •  The flu can make long-term health problems worse, even if they were well managed. So, those with diabetes, asthma, chronic heart disease, etc., are at higher risk for flu related complications.
  • Severe flu disease is typically experienced by people 65 and older, with most flu-related death (75% - 80%) occurring in this age range.

PREVENTION:

  • Wash your hands frequently (Soap and water or alcohol- based rub) to protect from germs.
  • Clean and disinfect often touched surfaces at home and work, especially when someone is ill. 
  • Avoid touching your eyes, nose or mouth.
  • Get plenty of sleep, be physically active, manage your sleep, drink plenty of fluids, and eat nutritious food.
  • The single best way to prevent seasonal flu is to get vaccinated each year.

Availability.

  Locally, the flu vaccine is available for free or low cost at:  

Walgreens, CVS, Mercy to Mankind Clinic, Community  Health, Howard Brown Health Halsted

And

HEARTLAND HEALTH CENTER , COOK COUNTY HOSPITAL, MT SINAI HOSPITAL

 IDOA requires this form to be renewed each year for employees with direct contact with participants.

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I understand that due to my occupational exposure to blood or potentially infectious materials, I may be at risk of acquiring Hepatitis B Virus (HBV) infection. I will be given the Hepatitis B vaccination, at no charge to myself, provided by KAFF HOMECARE INC. 

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I understand that due to my occupational exposure to blood or other potentially infectious materials, I may be at risk of acquiring Hepatitis B Virus (HBV) infection. I have been given the opportunity to be vaccinated with Hepatitis B vaccine, at no charge to myself. I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with Hepatitis B vaccine, I can receive the vaccination at no charge to me.

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If I decline the vaccination series, I release KAFF HOMECARE INC, from all liability regarding the contractions of Hepatitis B In the performance of my employment duties.
I understand that due to my occupational exposure to blood or other potential infectious material I may be at risk of contracting the Hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with the Hepatitis B vaccine, at no charge to myself. However, I decline the mentioned vaccine I continue to be at risk of acquiring Hepatitis B, a serious disease.

In the future if continue to have occupational exposure to blood or other potential Infectious materials and want to be vaccinated, I can receive the vaccination series at no charge.

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I understand that due to my occupational exposure to blood or other potentially infectious materials that I may be at risk of acquiring hepatitis B vaccine series at no charge to myself.

Choose one below: *

Note: Should you decline this vaccine you continue to be at risk of acquiring hepatitis B, a serious disease. If in the future you continue to have occupational exposure to blood or other infectious materials, you may receive the vaccination series at no charge.

* The series consists of 3 vaccinations. The Initial, a second  1 (one) month later and a third injection 5 months later.

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*If you have elected to receive the Hepatitis B vaccination series, arrangements will be made.

Choose one below: *

The risks and benefits of receiving a PPD test and the risks of acquiring tuberculosis from work exposure have been explained to me. I acknowledge that no guarantees have been made to me regarding the effectiveness of this testing or the absence of adverse reactions to the testing. I understand this information and have had all my questions answered to my satisfaction. I voluntarily give my consent to receive the TB skin testing.

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I have been given the opportunity to be tested for tuberculosis; however, I am choosing to decline the PPD test at this time.

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Caregiver Job Descriptions, Responsibilities and Protocol - 1 HR

Professional caregivers must follow policies and procedures such as arriving on-time to their caregiving work assignment, taking care plan notes, and following all necessary care duties and safety protocol. Home Caregivers, also called Home Care Aides or Home Health Aides, are expected to follow a basic job description of duties, Just as with all professional jobs.

Communication Skills Including Seniors with Memory Loss - 0.75 HR Communication

Learn how to effectively communicate with seniors from different generations, individuals with Alzheimer disease and other types of dementia, and those with hearing difficulties and special needs.

Understanding Plan of Care for Documenting Client Activities, Changes and Deviations - 1 HR 

Care Plan Notes

Learn proper caregiver skills for observing, reporting, and documenting daily activities, along with legal requirements and guidelines for subjective and objective notes regarding changes in the functional ability and mental status of the client.

Personal Care, Bathing, Dressing and Toileting - 1 HR

Personal Care

Learn how to safely and kindly assist senior clients and those with memory loss to take care of daily activities including bathing, skincare, hair care, mouth care, dressing, feeding, assistance with ambulation, exercise and transfers, positioning, toileting, and medication reminders.

Personal Care: Hair, Skin, Nall, Dental and Shaving Care - 1HR

Personal Care Part 2: Hair, Skin, Mouth Care, and Shaving

Learn personal care tasks skills for senior clients, including: hair care, skin care, nail care, shaving, and mouth care.

Bedbound Senior Care, Repositioning, Range of Motion - 1 HR

Bedbound Care

Bedsores or pressure ulcers develop when there is too much pressure on the skin, and are more common in bedridden patients. Safe bed care and repositioning can minimize the chance of bedsores. Learn daily exercise techniques to benefit bedridden clients.

Fan Prevention, Gait Belts, Riding in Automobiles - 1 HR

Assistance with Ambulation and Transportation

Safe adaptive equipment used for assisting clients with transfers from bed to chair to toilet to showers and in and out of wheelchairs. Learn types of transfers and devices used along with requirements for each device. Consider the Best and Safest Form of Transportation to Destination

Safe Transfers and How-to-Use a Hoyer Lift - 1 HR

Positioning, Lifting, Hoyer, and Safe transfers

Learn how to safely manage a transfer using a specialized Hoyer lift and to reposition after transferring.

Basic Hygiene, Infection Control, TB, Influenza - 1.25 HR

Hygiene, Infection Control, Infectious Diseases, Influenza

Learn how to maintain good hygiene for both the senior client and caregiver and safely protect yourself and control infections. How to wash hands, use gloves properly, protect your face and body, and assist seniors with good daily hygiene. Learn about the flu, how to protect yourself, those you care for, and recognize symptoms.

Maintaining a Clean, Safe and Healthy Environment - 1 HR

Cleanliness

Learn standards for maintaining a clean and healthy environment for your senior client and for everyone visiting and caring for them by using the proper products and following a scheduled cleaning routine based on care needs.

Basic Personal and Environmental Safety Precautions - 1 HR

Safety

Learn basic precautions for personal and environmental safety, including procedures to follow to protect both yourself and your senior client.

When and How to Use Restraints - 1.25 HR

Understanding Use of Restrains

Learn about the different types of restraints: Physical Restraints, Chemical Restraints, Seclusion and Alternatives to using restraints. Risk reduction and culture around appropriate use.

Emergency Procedures, Including Basic First Aid and Client's Emergency Preparedness Plan - 2 HRS

Emergency Preparedness and First Aid

Learn what emergencies require, basic first aid, such as cuts and burns, and what do when they happen. Learn what events are considered natural disasters and how to create and follow an emergency preparedness plan to protect yourself and your client. Understand environmental safety precautions for homes and when working at senior care facilities.

HIPAA: Confidentiality of Client Info HiTECH Act and Scenarios - 2 HRS

HIPAA part I

Understand confidentiality requirements for personal, financial and health information and the specifics of HIPAA, the Health Insurance Portability and Accountability Act and Who and What it is for as a caregiver. Health Insurance Portability and Accountability Act (HIPAA) of 1996 defines Covered Entities (CEs) and Business Associates (BAs). Find out more in this section. HiTech Act was an effort to speed up the transfer to electronic health records and put in place rules on how to safeguard the information.

HlPAA Part 2

HIPAA law and what it covers can be confusing. In this section, we will give specific scenarios to help you understand what is a violation and what isn't. If you are ever in doubt about sharing information, it is always best to be more cautious.

Medication Self-Administration: Proper Procedures, Dysphagia - 1 HR

Medication Self-Administration Procedures and Dysphagia

Medications may be monitored by senior caregivers, which means following the prescribed medication protocol when seniors are to take pre-arranged medications and confirming the medication has been swallowed or placed on the skin as directed.

Sometimes seniors with memory loss or other conditions may become resistant to taking medications. Learn how to effectively monitor medications and professionally manage issues around medication resistance. It is important to know how to properly monitor medication self-administration.

How to Detect, Report, and Prevent Abuse and Neglect - 2 HRS

Elder Abuse and Neglect

Learn the types of abuse and neglect, legal requirements for reporting (and legal punishments for not reporting), and how to protect your senior client and yourself from physical, emotional, sexual, and financial abuse.

Respiratory Services and Cardiovascular Systems - 1.5 HR

How the Heart Beats and Lungs Breathe

Overview of the anatomy of the cardiovascular system and respiratory system and conditions seniors may frequently experience as these systems experience aging.

Understanding Alzheimer Disease and Dementia - 0.50 HR

Alzheimer Disease

Alzheimer Disease is one type of memory loss with a set of symptoms and treatments which are separate from other types of memory loss.

Maintaining Safe Environments for Alzheimer's - 0.25 HR

Safety in the Home

Creating a safe home environment is very important as Alzheimer progresses.

Problem Solving for Challenging and Aggressive Behaviors in Dementia Care - 0.50 HR

Dealing with Challenging Behaviors

Managing patients with Alzheimer Disease and Dementia can create difficult challenges for the caregiver. Most importantly, as a caregiver, you must remember to stay calm and reassuring.

Sexual Harassment in the Workplace - 0.50 HR

Harassment Defined

Verbal or physical conduct that shows hostility towards someone defines harassment. Learn how to understand and identify harassment.

Sexual Harassment Prevention Positive Behaviors, Responses, and Scenarios - 0.50 HR

Positive Behaviors, Responses

All employees should contribute to a positive environment and understand how to both support others and identify and report inappropriate behavior. Part of building a positive environment requires learning acceptable behavior and understanding what can be taken the wrong way. Take a look at the hypothetical sexual harassment scenarios.

Bystander Intervention Model Training and Scenarios - 1 HR

Defining Bystander Intervention

Learn when to intervene in situations that are potentially harmful or there is a risk of sexual harassment to another and how to safely help the person.

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 Please kindly follow the instructions provided below and respond to the relevant questions to the best of your knowledge.

1. Mr Smith tells you he is going to vomit after taking his new medication the doctor ordered, so he is not taking it, What should you do *
2. Wearing disposable gloves while changing bed linens: *
3. When handling dirty linen and clothes it is best to: *
4. When reporting or recording information it is important to: *
5. If you make a mistake on your daily notes you should: *
6. When reporting a change in the Client’s condition you need to tell the supervisor all the following except: *
7. You should write a note in the daily care record at least: *
8. Good hand washing technique is important because: *
9. Wearing disposable gloves while changing bed linen: *
10. When handling dirty linen and clothes, it is best to: *
11. When cleaning up a spill that possibly contains blood, you should: *
12. When considering the homemaker’s role in reducing the spread of germs, the Homemaker would do all the following except: *
13. The role of Homemaker is to provide support measure such as: *
14. The client’s bedroom has a polished hardwood floor, which is the best method of daily cleaning: *
15. Immediately after washing dishes in hot soapy water they should be: *
16. In preparing a meal, you accidentally break a clean dish, after cleaning up the broken pieces you should: *
17. All of the following activities is what a homemaker should routinely perform, except: *
18. Wrinkles in the client’s bed linen may cause: *
19. Which one of the following statements is NOT true: *
20. When caring for a client where there are children in the home, which of the following would be dangerous: *
21. You discover cockroaches in the client’s home: *
22. To prevent fires in the home, which of the following is NOT correct: *
23. Mrs. Angel lives alone and is homebound. When you arrive at the home, the door is locked and, although it is the middle of the day, you can see lights in the living room. When you knock, you can hear a low moan coming from somewhere in the house. You should: *
24. Fire safety instruction is important: *
25. While cooking dinner you accidentally spill boiling water on your head. You should: *
26. A stranger comes to the door claiming that their car broke down and asks to use the phone, You should: *
27. Your client suddenly complains of intense squeezing pain in the chest that goes down his arm. The client is sweating and holds his chest, You should: *
28. The client offers you money, You should: *
29. Wrinkles in the client’s bed linen may cause: *
30. In which of the following situations would the Homemaker at a company be held responsible for damages caused by a broken lamp in a client’s home? *
31. A client named Ms. Green tells you she is very upset with you and demands that you tell her the supervisor she can call to report you. The correct action is: *
32. You are caring for Mrs. Jones, a terminally ill client. The neighbor stops by to visit and asks you if Mrs. Jones is going to die. You should reply: *
33. When caring for a client who is from another culture different from yours, remember that: *
34. Elderly people may not eat a well-balanced diet due to: *
35. The best example of a low-fat breakfast is: *
36. Very good sources of protein are: *
37. Which of the following statements are correct? *
38. It would be UNSAFE to: *
39. You can use communication skills when: *
40. Communication includes: *
41. If a client is having a hard time hearing, You should: *
42. Your client has expressed some religious belief you do not agree with, You should: *
43. Ways to foster communication includes all EXCEPT: *
44. A homemaker or caregiver should always treat clients with dignity and respect, regardless of their condition or behavior? *
45. A caregiver should always administer medication to a client when they request it, even if it is not part of the care plan? *
46. A caregiver should always protect a client's privacy and maintain confidentiality about their personal and medical information? *
47. It’s acceptable to share a client’s personal information with their neighbor if they are concerned? *
48. It is okay to leave a client unattended for long periods if they are sleeping? *
49. Proper handwashing before and after providing care helps prevent the spread of infections? *
50. If a client refuses care, should the caregiver force them to comply for their own safety? *
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Our Promise to You

At KAFF HOMECARE INC, care goes beyond the physical. We aim to nurture emotional well-being, build lasting connections, and bring comfort into every moment we share. We don’t just provide care—we build relationships rooted in trust, compassion, and respect.

Let us help you or your loved one thrive, not just survive.

Contact us today to learn how we can support you. We’re here to answer your questions, guide you through the process, and show you why we’re the trusted choice for families like yours.

Because at KAFF HOMECARE INC, home is where the heart is.

2025 KAFF HOMECARE INC. Designed by KAFF HOMECARE INC. IT

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