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Personal Information

Position Applying For *

First Name *

Middle Name

Last Name *

Social Security Number *

Driver's License or State ID Number *

Telephone Number *

Alternate Number

Street Address *

City *

State *

ZIP Code *

Email Address *

Select the languages you speak

English French Igbo Spanish Yoruba Other

If "Other", please type your language here

Attach Resume (optional — PDF or Word)

General Information

Are you legally eligible for work in the United States? *

Yes No

If yes, verification will be required.

Have you ever applied to or worked for Kaff Homecare, Inc. before? *

Yes No

Are any of your relatives currently working for Kaff Homecare, Inc.? *

Yes No

Have you ever been convicted of a felony? *

Yes No

Employment Request

Minimum Salary Requested (USD) *

If applicable, are you available for overtime? *

Yes No

What is the earliest date you can begin work? *

How did you hear about this position?

Recruited Internet Job Posting Newspaper Classified Company Website Other

Employment History

Please begin with your most recent employment.

Employer 1

Employer *

May we contact this employer? *

Yes No Not Applicable

Address *

Supervisor *

Telephone Number *

Dates of Employment: From *

To *

Position *

Pay or Salary — Start (USD) *

Pay or Salary — Final (USD) *

Duties *

Reason for Leaving *

Employer 2 (if applicable)

Employer

May we contact this employer?

Yes No Not Applicable

Address

Supervisor

Telephone Number

Dates of Employment: From

Position

Pay or Salary — Start (USD)

Pay or Salary — Final (USD)

Duties

Reason for Leaving

Employer 3 (if applicable)

Employer

May we contact this employer?

Yes No Not Applicable

Address

Supervisor

Telephone Number

Dates of Employment: From

Position

Pay or Salary — Start (USD)

Pay or Salary — Final (USD)

Duties

Reason for Leaving

Employer 4 (if applicable)

Employer

May we contact this employer?

Yes No Not Applicable

Supervisor

Telephone Number

Dates of Employment: From

Position

Pay or Salary — Start (USD)

Pay or Salary — Final (USD)

Duties

Reason for Leaving

Education

High School / GED

High School / GED *

Address *

Course of Study *

Degree Obtained *

College / University

Address

Course of Study

Degree Obtained

Graduate School

Address

Course of Study

Degree Obtained

Vocational / Specialized

Address

Course of Study

Degree Obtained

Military

Military service? *

Yes No

Branch

Specialized Training

References

Reference 1

Name *

Company *

Title *

Contact Information *

Reference 2

Name *

Company *

Title *

Contact Information *

Reference 3 (optional)

Name

Company

Title

Contact Information

Signature / Certification

I certify that the facts set forth in this application are true, complete, and correct to the best of my knowledge. I understand that any misrepresentations, falsifications, or omissions on this application can be grounds for rejection of my application or, if this company employs me, for my immediate termination from employment. I authorize Kaff Homecare Inc. to make any necessary inquiries and investigations into my education, military, or employment history. I further authorize, unless otherwise indicated on this application, the release of my information to Kaff Homecare Inc. by any of the schools, services, or employers listed on this application. *

Name of Applicant *

Date *

Health Care Worker Background Check

Authorization and Disclosure for Criminal History Records Information (CHRI) Check

State of Illinois (Illinois Department of Public Health)

I hereby authorize the Illinois Department of Public Health (the Department), the Department's designee, educational entities that train and/or test health care workers, staffing agencies, my current or potential employer, or a health care facility where I want to volunteer to initiate/request a CHRI check on me. I further authorize the Illinois State Police (ISP) and/or the Federal Bureau of Investigation (FBI) to release information relative to the existence or nonexistence of any criminal record which it might have concerning me, to any initiator/requestor solely to determine my suitability for training or testing in a health care training program, employment, continued employment, or to work as a volunteer. I further authorize any entity that maintains criminal records relating to me, including but not limited to a local unit of government in any State, to release those records to the ISP, FBI, or the Department. I authorize the Department to provide any health care facility, training program or staffing agency to which I have provided this authorization and disclosure form a copy of my ISP CHRI and a determination of eligibility of the FBI CHRI. I certify that the ISP, FBI, any entity that maintains criminal records, the Department, and any of their employees or officers who furnish this information shall be held harmless from all liability which may be incurred as a result of releasing such information. I further acknowledge that an educational entity or health care employer shall not be liable for the failure to hire or retain me as an applicant, student, employee, or volunteer if I have been convicted of committing or attempting to commit one or more of the offenses stated in the Health Care Worker Background Check Act (225 ILCS 46/25).

I understand that any false statements or deliberate omissions on this document may be grounds for disqualification from employment, training, or volunteering; if discovered after employment, training, or volunteering begins, they can result in discipline up to and including my termination.

I understand that the information requested below regarding gender, race, height, eye color, hair color, weight, place of birth and date of birth is for the sole purpose of identification and the accurate gathering of criminal history record information, and that it will not be used to discriminate against me in violation of the law. I understand that the provision of my Social Security number is required by law. A facsimile or photographic copy of this authorization will be as valid as the original.

First Name *

Full Middle Name

Last Name *

Mailing Address *

City *

State *

Zip Code *

Other Names Used

Telephone *

States Where You Have Lived

Place of Birth (State, or Country if not US) *

Hair Color *

Weight *

Date of Birth *

Height *

Eye Color *

Social Security Number *

Gender *

Male Female

Race *

Chinese, Japanese, Filipino, Korean, Polynesian, Indian, Indonesian, Asian Indian, Samoan, or any other Pacific Islander Black or African American (Not Hispanic or Latino) Hispanic or Latino (Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin) American Indian, Eskimo, or Alaskan Native, or a person having origins in any of the 48 contiguous states of the United States or Alaska who maintains cultural identification through tribal affiliation or community recognition Of undeterminable race / of untold mixture Caucasian (Not Hispanic or Latino)

Have you ever had an administrative finding of Abuse, Neglect or Theft? *

Yes No

If "Yes", give full details and state

Have you ever been convicted of a criminal offense other than a minor traffic violation (do not include convictions that have been expunged, sealed or adjudicated delinquent)? *

Yes No

If "Yes", give full details of each offense and the state in which convicted

If you need more space for the details above, write on a separate sheet of paper and email it to: kaffhomecare2@gmail.com

Signatures / Certifications

Check all boxes to authorize your signature

I certify that the above is true and correct and give my consent for my name to appear on the Department's Health Care Worker Registry with the results of my criminal history records check. *I authorize all federal and state agencies, persons, and organizations that may have information relevant to this research to disclose such information to Kaff Homecare Inc. or its authorized agent(s). *I understand that this authorization is to be part of the written and signed employment application. *I also understand that I do not have to give authorization for a background check, but if I don't give permission, my employment application will not be processed further. *I understand that I have specific rights under the federal Fair Credit Reporting Act (FCRA) and may have additional rights under relevant State law. *I further authorize that a photocopy of this authorization may be considered as valid as the original. *I hereby certify that all statements on this form are true and correct to the best of my knowledge and belief. I understand that employment with Kaff Homecare Inc. is contingent upon the successful completion of a background check. *

Full Name *

Date

Telephone Number *

Former Name(s) and Date(s) Used

Current Address *

Date of Birth

Month *

Day *

Year *

Social Security Number *

Current Driver's License *

State *

List any other cities, states, and dates of residency during the last 10 years

City

State

From

City

State

From

City

State

From

City

State

From

Home Care Companion Job Description

Description

Home Care Companions provide service to individuals in their own homes and communities who need assistance caring for themselves as a result of old age, sickness, disability, and/or other afflictions. Home care may include light housecleaning, laundry, meal preparation, transportation, companionship, respite, and advice on such things as nutrition, cleanliness, and household activities. Home Care Companions 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

Provide companionship, friendship, and emotional support.
Talk, listen, share experiences, play games/cards, read to clients, etc.
Help keep clients in contact with family, friends, and the outside world.
Provide transportation to medical appointments, grocery stores, and errands.
Accompany clients to recreational and/or social events.
Assist with plans for visits and outings.
Write or type letters/correspondence; organize and read mail.
Plan trips and outings and possibly travel with clients.
Teach/perform meal planning and preparation.
Perform light housekeeping.
Participate in the Care Team by providing input and making suggestions.
Ensure service is delivered in accordance with Agency policies, procedures, and industry standards.
Monitor supplies and resources.
Evaluate the program and make recommendations, as indicated. Follow the written care plan.
Assist in basic client transfers, provided the client has been assessed as capable of ambulating without assistance, and/or another trained caregiver (including family) is involved in the transfer.
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.
Develop and maintain constructive and cooperative working relationships with others.
Make decisions and solve problems.
Assist with pet care.
Communicate with Supervisor and co-workers.
Attend orientation, in-service training sessions, and staff meetings.

Required Knowledge

Knowledge of home management skills.
Knowledge of principles and processes for providing client 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

Be aware of other people's reactions and understand why they react as they do.
Establish and maintain relationships.
Teach others.
Identify problems and determine effective solutions.
Apply reason and logic to identify strengths and weaknesses of possible solutions.
Understand written and oral instructions.
Communicate information orally and in writing; listen and understand the spoken word.
Work independently and in cooperation with others.
Determine or recognize when something is likely to go wrong.
Suggest a number of ideas on a subject.
Provide advice and consultation to others.
Observe and recognize changes in clients.
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.
May require similar social and cultural backgrounds with some clients.

I have read and understood the job description and agree to fulfill the position's responsibilities. *

Employee Name *

Date *

Agency Manager Name

Agency Supervisor Name

Please complete all required fields (*) before submitting.

Personal Information

Position Desired *

Date Available *

Type of Employment Desired

First Name *

Middle Name

Last Name *

Street Address *

Apartment, suite, etc.

City *

State *

ZIP Code *

Phone Number *

Alternative Phone Number

Email Address *

Do you have a valid driver's license?

Yes No

Class

CDL?

Yes No

Have you ever served in the military?

Yes No

Do you speak any other language(s)? Specify

Do you have the legal right to obtain employment in the United States?

Yes No

Can you perform the essential functions and responsibilities of the position for which you are applying?

Yes No

Do you require any special accommodation to perform required duties?

Yes No

Have you ever worked for Kaff Homecare, Inc.?

Yes No

Do any of your relatives work for Kaff Homecare, Inc.?

Yes No

List any current licenses, certifications, or registrations required for the position for which you are applying. Include date received.

License or Certification Number

Date of License

Expiration Date

Mandatory: All applicants with an Illinois license or CNA certification must provide the license or certification number and the date of such license or certification.

CPR or First Aid Certification — Training Date

Mantoux Test Date

Have you ever been convicted of any criminal or driving offense(s) other than a minor traffic violation?

Yes No

You must provide at least three current reference letters and/or the names of individuals with whom a reference interview can be conducted. Please give the full name, mailing address, and phone number of three references who have knowledge of your background and qualifications in the field.

Reference 1 *

Reference 2 *

Reference 3 *

Education and Skills

Level of Education Completed

High School GED College 0-3 Years Degree: Associate Bachelor Masters

Specify Major

Software Applications

Typing Words Per Minute

Experience

List your last 5 years of work experience.

01 — Employment

From

Beginning Salary (USD)

Ending Salary (USD)

Name of Employer

May we contact?

Yes No

Street Address

City

State

ZIP Code

Supervisor's Name

Phone Number

Title and Duties Performed

Reason for Leaving

02 — Employment

From

Beginning Salary (USD)

Ending Salary (USD)

Name of Employer

May we contact?

Yes No

Street Address

City

State

ZIP Code

Supervisor's Name

Phone Number

Title and Duties Performed

Reason for Leaving

03 — Employment

From

Beginning Salary (USD)

Ending Salary (USD)

Name of Employer

May we contact?

Yes No

Street Address

City

State

ZIP Code

Supervisor's Name

Phone Number

Title and Duties Performed

Reason for Leaving

04 — Employment

From

Beginning Salary (USD)

Ending Salary (USD)

Name of Employer

May we contact?

Yes No

Street Address

City

State

ZIP Code

Supervisor's Name

Phone Number

Title and Duties Performed

Reason for Leaving

05 — Employment

From

Beginning Salary (USD)

Ending Salary (USD)

Name of Employer

May we contact?

Yes No

Street Address

City

State

ZIP Code

Supervisor's Name

Phone Number

Title and Duties Performed

Reason for Leaving

Applicant Certification

I agree to carry out the designated responsibilities to the best of my ability. I have read the position description. I am aware there is a conditional period of 3 months prior to permanent employment. *I certify that I have given true, accurate, and complete information on this form to the best of my knowledge. I authorize the investigation of statements made in this application and understand that false information may be grounds for denial of my position and/or dismissal if I am employed. *

Name *

Date *

Certified Nursing Assistant Skills Checklist

Print Name *

Date

Directions: Please select a value for each skill to give us and interested facilities an assessment of your clinical experience. Each skill below requires a rating.

Rating key: 1 = No experience · 2 = Minimal experience / works with supervision · 3 = Independent / works without supervision in most cases · 4 = Senior / works at a supervisory or teaching level

Has knowledge of and can provide care and assist patients with the following tasks:

Ambulation

1234

CRUTCHES

WALKER

CANE

GAIL BELT

Personal Care

1234

A.BED

B.TUB

C.SHOWER

2.SKIN CARE

A.BACK RUB

B.DECUBITUS PREVENTION OR CARE

A.ASSIST AS NEEDED

B.USE OF ASSISTIVE DEVICES

A.CLEAN OR FILE OR TRIM WITH CLIPPERS

A.MOUTH CARE

B.BRUSH TEETH

C.DENTURE CARE

7.SHAVING: SAFETY RAZOR OR ELECTRIC RAZOR

Nutrition or Hydration

1234

1.FEEDING TECHNIQUES

2.ASSIST WITH EATING

3.USE OF FEEDING ASSISTIVE DEVICES

4.MEASURE AND RECORD INTAKE

5.ENCOURAGE FLUIDS

Assisting or Care of Patient with Bowel and Bladder Elimination

1234

1.BEDPAN OR URINAL

2.BEDSIDE COMMODE

3.CARE OF INCONTINENT PATIENT

4.STOMA CARE

5.BOWEL OR BLADDER TRAINING

6.MEASURE AND RECORD OUTPUT

Urinary Catheter Care

1234

1.PERINEAL HYGIENE

2.FOLEY CATHETER

3.SUPRA PUBLIC CATHETER

Transfer Techniques

1234

1.USE OF TRANSFER GAIT BELT

2.WEIGHT BEARING

3.NON-WEIGHT BEARING

4.MECHANICAL LIFT

5.WHEELCHAIR

Turning / Position Patient

1234

1. SUPINE

2. SIDE-LYING

3. IN CHAIR

4. IN BED

5. USE OF LIFT SHEET

Communication

1234

1. VERBAL

2. NON-VERBAL WITH COGNITIVELY IMPAIRED PATIENTS

Range of Motion Excersices

1234

1. ACTIVE

2. PASSIVE

3. COMBINATION

Take & Record Vital Signs

1234

A. ORAL

B. RECTAL

C. EAR CANAL

2. PULSE

A. APICAL

B. RADIAL

C. PEDAL

3. RESPIRATIONS

4. BLOOD PRESSURE

5. HEIGHT

6. WEIGHT

B. BED SCALE

A. STANDING

C. CHAIR SCALE

Safety Devices

1234

1. VEST RESTRAINT

2. (SOFT) WRIST / ANKLE RESTRAINT)

3. PADDED SIDE RAIL

4. SIDE RAILS

Mental Health & Social Services Needs

1234

1. DEMONSTRATES PRINCIPLES OF BEHAVIOR MANAGEMENT

2. PROVIDES EMOTIONAL SUPPORT TO PATIENT

3. ECOURAGES FAMILY SUPPORT

4. ECOURAGES PATIENTS TO MAKE PERSONAL CHOICES

5. REPECTS PATIENT'S RIGHTS AND DIGNITY, INCLUDING PRIVACY & CONFIDENTIALITY

6. ENCOURAGES SELF-CARE AS ABILITY ALLOWS

8. KNOWLEDGE OF DOMESTIC VIOLENCE AND VIOLENT INJURY REPORTING STATUES

7. KNOWLEDGE OF ADULT, CHILD AND ELDER ABUSE REPORTING STATUTES

Safety / Emergencies

1234

1. RECOGNIZES & REPORTS SAFETY HAZARDS

2. RECOGNIZES & REPORTS EMERGENCIES AND RESPONDS APPROPRIATELY

3. HANDLES O2 SAFELY

4. OBSERVES, REPORTS & DOCUMENTS CHANGES IN BODY FUNCTIONS, BEHAVIOR

Care of Prosthetic Devices

1234

1. LIMBS

2. EYE GLASSES

3. HEARING AIDS

Specimen Collection

1234

1. URINE

2. STOOL

3. SPUTUM

Understand and Can Perform

1234

A. ACE BANDAGES

B. SUPPORT STOCKINGS

2. CARE OF THE DECEASED

1. DIABETES

2. CANCER

3. HEART DISEASE

4. O2 THERAPY

5. RESPIRATORY DISEASE

6. TERMINAL

7. INFECTIOUS DISEASE

Certification

To the best of my knowledge, the information I have provided on this skills checklist and application is true and correct. *

Name *

Date

Please complete all required fields and skill ratings (*) before submitting.

Please provide the following information

Name *

Date of Hire

Rating scale: 1 = Clinicals Only · 2 = Some Experience · 3 = Experienced · 4 = Can Perform Task Independently

Neurological System

1234

NEURO ASSESSMENT/NEURO VITALS

HALO TRACTION

SEIZURE PRECAUTIONS

SPINAL CORD INJURY

HEAD INJURY

PRE / POST NEUROLOGICAL SURGERY

REHABILITATION OF THE NEURO PATIENT

CNS INFECTIONS

PARKINSONS

AUTONOMIC DYSREFLEXIA

ALZHEIMERS

CHRONIC C.V.A / T.I.A

USING GLASCOW COMA SCALE

Cardiovascular

1234

CAPILLARY REFILL

EDEMA

HEART TONES

PULSES

ANGINA (ACUTE AND CHRONIC)

ASSESSING AND TREATING ORTHOSTATIC BP

ASSESSING ABNORMAL HEART TONES

ANTIEMBOLIC DEVICES

Patients with Respiratory Problems

1234

Assessing the Respiratory System including:

BREATH SOUNDS

BREATHING PATTERN / EFFORT

COUGH EFFORT

SKIN AND NAIL BED COLOR

SPUTUM (COLOR/CHARACTER)

ACUTE AIRWAY

NASOPHARYNGEAL AIRWAY

OROPHARYNGEAL AIRWAY

NASAL CANNULA

MASK

O2 SATS

DEMONSTRATING PROPER USE OF AMBU BAG

SUCTIONING: LENGTH OF TIME SUCTIONING

HYPERVENTILATION

VENTILATOR SETTINGS

DOCUMENTATION

RESPIRATORY FAILURE

RESPIRATORY INFECTIONS

STATUS ASTHMATICUS

RESPIRATORY DISTRESS SYNDROME

PULMONARY EDEMA

PULMONARY EMBOLI

TENSION PNEUMOTHORAX

TRACHEOSTOMY

USE OF INCENTIVE SPIROMETER

Gastrointestinal

1234

ASSESSING BOWEL SOUNDS

IDENTIFYING ABNORMALITIES

CARING FOR PATIENT ON TOTAL PARENTERAL NUTRITION

INSERTING /MAINTAINING FEEDING TUBES (NG)

ADMINISTERING TUBE FEEDINGS

ABDOMINAL WOUNDS OR INFECTIONS

ILEOSTOMY/COLOSTOMY

STOOL TESTS

I&O: SHIFT VOLUMES AND TOTALS INCLUDING MARKING AND/

OR MEASURING AMOUNTS OF URINE, GASTRIC FLUID

NG DRAINAGE, EMESIS, DIARRHEA

Genitourinary / Renal

1234

INSERTING/MAINTAINING URINARY DRAINAGE TUBES:

INSERTION OF FOLEY

MANAGING UROSTOMY

MANAGING SUPRAPUBIC CATHETER

PLACING CONDOM CATHETER

CARING FOR PATIENTS WITH CHRONIC RENAL FAILURE

CARING FOR PATIENT RECEIVING DIALYSIS

ASSESSING FLUID AND ELECTROLYTE PROBLEMS

KNOWLEDGE OF UA VALUES

COLLECTING SPECIMENS

Endocrine

1234

CHECKING CAPILLARY BLOOD GLUCOSE

DIABETIC TEACHING

TREATING HYPO/HYPERGLYCEMIA

INSULIN ADMINISTRATION

HORMONE THERAPY

Muscuskeletal

1234

TRACTION

BRACES

CASTS

COLLARS

SLINGS/SPLINTS

SKELETAL AND SKIN TRACTION

CLINITRON

ROTO REST

CRUTCH WALKING/WALKERS

CIRCELECTRIC

ARTHROSCOPY/ARTHROTOMY

JOINT/BONE DISORDERS

TOTAL KNEE REPLACEMENT

TOTAL HIP REPLACEMENT

AMPUTATION

Vital Signs and Weights

1234

BP, INCLUDING ORTHOSTATIC

PULSE, RADIAL

TEMPERATURE, ORAL

TEMPERATURE, RECTAL

RECOGNIZING CARDIAC ARREST

CARDIOVERSION DEFIBILATION

ACTIVATING CODE TERM

BRINGING EMERGENCY EQUIPMENT TO ROOM

DNR STATUS

TEMPERATURE, AXILLARY

TEMPERATURE, TYMPANIC

RESPIRATIONS

WEIGHT, POUNDS AND KILOGRAMS

APPLYING OXIMETER

ELECTRONIC THERMOMETER

AUTOMATIC BP MACHINE (DYNAMAP)

STANDING

CHAIR

BED

RECODING AND REPORTING INFORMATION

Hygiene / Skin

1234

RISK FACTORS FOR SKIN BREAKDOWN

OBSERVING, RECORDING AND REPORTING PRESSURE POINTS FOR REDNESS OF BREAKDOWN

RECORDING AND REPORTING HYGIENE/SKIN//BREAKDOWN

BATHING (SHOWER/TUB/ARJO)

USE OF SHOWER CHAIR

USE OF BATH/SHOWER BOAT

ORAL CARE INCLUDING PATIENTS WHO ARE NPO, COMATOSE, WITH DENTURES

PERI CARE

FOOT CARE FOR PATIENTS WITH IMPAIRED CIRCULATION OF SENSATION

INCONTINENCE CARE

SHAVING AND PRECAUTIONS

SPECIAL BEDS/MATTRESSES

HEELS AND ELBOW PROTECTION

FOOT CRADLES

Nutrition

1234

ESTIMATING INTAKE

SETTING UP FOR MEALS

ASPIRATION PRECAUTIONS

NOURISHMENTS

FEEDING PATIENTS

COUNTING CALORIES

FLUID RESTRICTION

NPO

RECORDING AND REPORTING NUTRITIONAL INFORMATION

Care Routine

1234

ROOM PREPARATION

VS. HEIGHT AND WEIGHT

INVENTORY AND DISPOSITION OF BELONGINGS

ROOM ORIENTATION, CALL BELL

BASIC COMFORT MEASURES

PREPARING FOR AND EXPLAINING ROUTINES TO PATIENT

POST MORTEM CARE

Safety and Activity

1234

DETERMINING PATIENT ID

IDENTIFYING/RESPONDING TO SAFETY HAZARDS

DETERMINING NEED FOR ADDITIONAL HELP

SUBSTANCE

PHYSICAL

EMOTIONAL

MAINTAINING CLEAN , ORDERLY WORK AREA

HANDLING HAZARDOUS MATERIALS

PROPER BODY MECHANICS

ROM EXERCISES

TRANSFER TO BED, WC, COMMODE WITH OR WITHOUT DEVICE

TURNING AND POSITIONING

REPORTING BROKEN EQUIPMENT

AMBULATING WITH OR WITHOUT DEVICE

PATIENT SAFETY MODULE

USE OF HOYER LIFT (DEXTRA/MAXI)

BED OPERATION

USE OF WHEEL LOCKS

USE OF ALARMS (BED, PATIENT, UNIT)

USE OF CALL LIGHT

APPLICATION AND DOCUMENTATION OF RESTRAINTS: BELT, INCLUDING SEAT BELT WRIST/ANKLE VEST USE OF SEIZURE PADS

Infection Control

1234

GLOVES

GOWN

MASK/GOGGLES

PROTECTIVE/REVERSE ISOLATION

BRODY SUBSTANCE ISOLATION

TB PRECAUTIONS

MRSA PRECAUTIONS

HAND WASHING

INFECTIOUS/HAZARDOUS WASTE DISPOSAL

SUPPLY/EQUIPMENT DISPOSAL

USE OF DISPOSABLE THERMOMETER

USE OF CPR MASK/BAG

DISPOSAL OF SHARPE

Line Skills

1234

VENIPUNCTURE FOR SPECIMEN

ADMINISTERING BLOOD AND BLOOD PRODUCTS

STARTING IV

CHANGING IV SITES

CHANGING IV DRESSINGS

CHANGING IV TUBING

ADMINISTERING FLUIDS ON CONTINUOUS IV PUMPS

SETTING UP AND MONITORING PCA

OBTAINING CENTRAL VENOUS/PERIPHERAL VENOUS BLOOD

USING PICC, HICKMAN, TRIPLE LUMEN CATHS

SET UP AND MONITORING FOR TPN

Medication and Administration

1234

CIMETIDINE (TAGAMET)

DIAZEPAM (VALIUM)

DURAMORPH

FUROSEMIDE (LASIX)

HEPARIN

INSULIN

TERBUTALINE

THEOPHYLLINE

VERAPAMIL (CALAN)

ORAL MEDICATIONS

LORAZEPAM (ATIVAN)

MORPHINE

NALOXONE (NARCAN)

NITROGLYCERINE

PENTOBARBITAL

PHENYTOIN (DILANTIN)

POTASSIUM CHLORIDE

TOPICAL MEDICATIONS

VAGINAL

RECTAL

ORDERING MEDS

Other Skills

1234

PROVIDING EDUCATION TO PATIENT FAMILY RELATED TO MEDICAL CONDITION, SELF CARE AND HEALTH CARE HABITS

USING COMPUTERIZED TOOLS EFFECTIVELY

Communication

1234

USING APPROPRIATE ABBREVIATIONS

IDENTIFYING NEED FOR ALTERNATE COMMUNICATING MECHANISMS

CHANGES IN PATIENT CONDITION

PATIENT NEEDS, COMPLAINTS AND CONCERNS

UNUSUAL INCIDENTS

REINFORCING RN TEACHING WITH PATIENT

SELECTING AND USING FORMS APPROPRIATELY

USING ALTERNATE COMMUNICATION TOOLS/DEVICES

Unit Activity

1234

IDENTIFYING UNUSUAL INCIDENTS ON THE UNIT THAT REQUIRE REPORTING

LOCATING AND USING APPROPRIATE REFERENCE MATERIALS

COMPLETING RISK MANAGEMENT REPORTS AS NEEDED

CHARGING FOR PATIENT CARE ITEMS

OBTAINING NEEDED SUPPLIES AND EQUIPMENT

USING TELEPHONE SYSTEM

Miscellaneous

1234

CHEM 7, CHEM 10

CBC

SERUM DRUG LEVELS

PAIN MANAGEMENT

CARING FOR DRAINS/TUBES (I.E. HEMOVAC, PENROSE)

MONITORING AND ASSESSING I & O

PERFORMING COMPLEX DRESSING CHANGES

ALERT CHARTING

Confirmation

1234

Confirmation

By submitting, I confirm that the ratings above accurately reflect my experience.

Full Name *

Date

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In Home Service Worker Job Description

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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Supervisor Name

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Homemaker Job Description

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 client's 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, 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 establish 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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Employment at Will

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 subject 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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Supervisor Printed Name

Signature

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Drug-Free Workplace Policy Consent Form

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 Directors, 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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Administrator Signature

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Please include completed form with new hire papers.

Employee Responsibility

I understand and agree that as an employee of KAFF HOMECARE INC. there are no guaranteed hours or visits 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.

Employee’s Printed Name *

Employee Signature *

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Supervisor Signature

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Notification of Illinois Law Regarding Unemployment Benefits

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.

In Home Service Worker Name (PRINT) *

In Home Service Worker Signature *

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Social Security Number *

Employer Witness

Date *

General Abuse Policy

Child Abuse

Section 11166 of the Penal Code requires that the child care custodian, health practitioner, or in home service worker of a child protective agency who has knowledge of/observes a child (in his/her professional capacity or within the scope of his/her employment) whom he/she knows or reasonably suspects has 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 report within thirty-six (36) 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 services agencies, or local law enforcement agencies who (in their professional capacity or within the scope of their employment) 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-described abuse should be reported to the Long-Term 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 results 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 65 years or older and dependent adults are defined as persons between the ages of 18 and 64 whose physical limitations restrict their ability to care for themselves.

General Abuse

Section 11160 of the Penal Code requires health practitioners who, in their professional capacity or within their scope of employment, provide medical 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 agency, 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, and others as defined in the Business and Professions Code, as well as additional practitioners as defined in Section 11166 of the Penal 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 disciplinary action against the RN's license.

I certify that I 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

The customer's/client's home is “your place of business”; you must conduct yourself appropriately as you are at work.

You must NOT take friends, children or family to work.
Call ahead and advise the customer when you are running late.
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.
Notice of absence must be given not later than 4 hours before your scheduled start time, and must be by phone call only (NOT SMS, INSTAGRAM OR OTHER SOCIAL MEDIA).
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.
The customer/client may allow you to leave, but you MUST NOT leave on your own.
You should call your supervisor in advance when you cannot complete your scheduled assignment.
All paperwork is to be completed in a timely, accurate manner. Any falsification of documentation results in disciplinary action, including termination. Falsification of timesheets is FRAUD.
Attendance records must be accurate. Signing into CARE via the check-in system is mandatory.
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. Any fees for service, salaries and/or contract fees earned in violation will be owed to the company immediately.
You MUST NOT solicit the customer to otherwise hire your services in any way, shape or form.
Employees are STRICTLY PROHIBITED FROM DRIVING THE CUSTOMER IN THE EMPLOYEE'S OWN VEHICLE while on duty.
Employees may run errands for the customer, in the employee's own vehicle, within a reasonable distance (grocery, post office, pharmacy, etc.).
Employees may accompany customers in their (customer's) own vehicle or in commercial transport.
Personnel must not allow private interests to conflict with those of their patients.
Your personal business MUST remain personal. DO NOT discuss your affairs with the customer.
You are not permitted to ask for or accept a loan or gift of money or object of material value from patients, their families, or caregivers.
Payroll and administrative issues are your business. Do not discuss them with the customer.
Refusal or deliberate failure to carry out instructions given by a supervisor is prohibited.
Fighting or creating a disturbance on organization premises or in a patient's home is prohibited.

Failure to adhere to any of the above, 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.

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Sexual Harassment Policy

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 specifically 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 President, or the incident relates to or involves the President, the Head of the Homecare/Home Service 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 of this policy:

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.
Giving favorable treatment in any way to an applicant or employee because that person has shown a willingness to perform sexual activities.
Making unwelcome or unwanted physical contact. This includes patting, pinching, brushing up against, hugging, cornering, kissing, fondling, or any other similar physical contact considered unacceptable by another individual.
Verbal abuse 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; and any other tasteless, sex-oriented comments, innuendoes, or offensive actions.
Displaying sexually suggestive objects or pictures, including nude photographs, in the workplace.
Any other sexually oriented conduct that would seriously interfere with another's work performance.

I agree to abide by this sexual harassment policy *

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Confidentiality of Client Form (HIPAA)

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 affairs 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 an employee in legal proceedings.

Information about clients or the agency is not to be given to the media. This is essential for the 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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Employee Signature *

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Addendum to Employment Agreement

As 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 Non-Competition

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, whether as a proprietor, partner, director, officer, joint venturer, investor, lessor, representative, lender, guarantor, or other participant, for any business, individual or entity engaged in providing home health care/home care or any other services for which KAFF provides, including any entity employing personnel in any similarly 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 employee's spouse, parent or children, in one or a series of transactions, owns, manages, operates, controls, invests or acquires any interest in, or otherwise engages or participates in the business of, whether as a proprietor, partner, director, officer, employee, joint venturer, independent contractor, consultant, investor, lessor, agent, representative, lender, guarantor, or other participant (collectively referred to as a “relationship”) in any business, individual or entity engaged in providing home health care/home care or any other services for which KAFF provides, including any entity employing personnel in any similarly situated position as that held by the Employee with KAFF, agrees to disclose the relationship within five (5) business days to the Officers of KAFF. Disclosure of such relationship does not waive any right of KAFF.

Covenant of Non-Solicitation

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 not to solicit or recruit, directly or indirectly, any employees of KAFF, nor encourage employees in the employment of KAFF to breach the terms of their agreement with KAFF.

Covenant of Non-Disclosure

The term “confidential information” as used in this 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 from 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 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 assistants, USB drives, CD/DVD or other medium. Following disclosure, upon request of KAFF, the employee agrees to immediately and irrevocably destroy or deliver it as directed by KAFF.

Covenant of Non-Disparagement

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 not to, directly or indirectly, copy, take, or remove from KAFF premise(s) any of KAFF's books, records, customer lists, 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 the sole and exclusive property of KAFF. The Employee agrees not to use a personal computer, electronic equipment or media including USB 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 KAFF, including but not limited to computer equipment, cellular phones, global positioning systems, books, records, customer lists or any other document or material, to KAFF within two (2) business days of termination of employment. The Employee also agrees to be liable to KAFF for any equipment and property that is not returned to KAFF.

Employee Print Name *

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Employee Statement of Confidentiality

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 of 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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Supervisor’s Signature

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Acknowledgement

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

Name *

Employee’s Signature *

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Client Transportation Disclaimer

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 it 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 cause of action for damages, cost, loss of services, expenses, or compensation on account of, or hereafter growing out of, any accident which may happen as a result of the transportation I provide.

Employee’s Signature *

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I intend to drive my client in my personal vehicle I do NOT intend to drive my client in my personal vehicle

Vehicle Emergency Policy

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

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

Acknowledgement of Limitations on Marketing and Recruiting Activities Under the Community Care Program

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/PowerPoint 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: 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 (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; and placement of name on the Adult Protective Service Registry.

Original of this acknowledgement should be maintained in each employee's personnel file.

Agency Name

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Declination of Influenza Vaccination

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 contract influenza, I will shed the virus for 24–48 hours before influenza symptoms appear. My shedding the virus can spread influenza infection to clients.
If I 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 change almost every year, which is why a different influenza vaccine is recommended each year.
I cannot get 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, and 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.

Name *

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Annual Influenza Immunization Information

I have been informed by my employer about the following:

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. 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 deaths (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 stress, 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, Heartland Health Center, Cook County Hospital, and Mt. Sinai Hospital.

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

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Supervisor Signature

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Hepatitis B Vaccination Approval

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I would like to receive the hepatitis B vaccine series I decline the hepatitis B vaccine series at this time

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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Date

Hepatitis B Vaccination Declination

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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Release of Liability Waiver and Vaccine Declination

If I decline the vaccination series, I release KAFF HOMECARE INC. from all liability regarding the contraction of Hepatitis B in the performance of my employment duties.

I understand that due to my occupational exposure to blood or other potentially infectious materials, 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, if I decline the mentioned vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease.

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

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In Home Service Worker — Hepatitis B

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

Employee Name *

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I would like to receive the hepatitis B vaccine series I decline the hepatitis B vaccine series at this time

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 one (1) month later, and a third injection 5 months later.

Employee Name *

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

Tuberculosis Skin Test — Approval / Declination

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I approve the tuberculosis (PPD) skin test I decline the tuberculosis (PPD) skin test

Approval

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.

Declination

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

Signature

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Pre-Service Training: 24-Hour

I acknowledge that I have completed and understand the following 24-hour Pre-Service Training modules:

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

Learn how to effectively communicate with seniors from different generations, individuals with Alzheimer's 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

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

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, Nail, Dental and Shaving Care — 1 HR

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

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

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.

Fall Prevention, Gait Belts, Riding in Automobiles — 1 HR

Safe adaptive equipment used for assisting clients with transfers from bed to chair to toilet to shower and in and out of wheelchairs. Learn types of transfers and devices used, along with requirements for each device, and consider the best and safest form of transportation to a destination.

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

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

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 and those you care for, and how to recognize symptoms.

Maintaining a Clean, Safe and Healthy Environment — 1 HR

Learn standards for maintaining a clean and healthy environment for your senior client and 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

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

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

Learn what emergencies require, basic first aid such as cuts and burns, and what to 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.

HIPAA: Confidentiality of Client Info, HITECH Act and Scenarios — 2 HRS

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. The 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. Specific scenarios help you understand what is a violation and what isn't.

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

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. Learn how to effectively monitor medications and professionally manage issues around medication resistance.

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

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

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

Understanding Alzheimer's Disease and Dementia — 0.50 HR

Alzheimer's 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

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

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

Managing patients with Alzheimer's 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

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

All employees should contribute to a positive environment and understand how to both support others and identify and report inappropriate behavior.

Bystander Intervention Model Training and Scenarios — 1 HR

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

Employee Signature *

Sign here with your mouse or finger

Presenter / Supervisor

Date *

Homemaker Competency Evaluation

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

Observing and Reporting

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? *

Tell him he must take it if he wants to get well Tell his wife to make him take it Call the supervisor about what he should do All of the above

2. Wearing disposable gloves while changing bed linens: *

Protects you and your client from the spread of germs Means your client is incurable Is never necessary unless the client has AIDS None of the above

3. When handling dirty linen and clothes it is best to: *

Shake linen and clothing before washing them Put dirty linen and clothes on the floor Place dirty linens and clothing in a clothes hamper or plastic bag until they can be washed Place them in the microwave and heat them up

4. When reporting or recording information it is important to: *

Report and record what the nurse feels is wrong Report and record exactly how you feel about the situation Report and record what the family feels is wrong Report and record exactly what you see

5. If you make a mistake on your daily notes you should: *

Use white-out and write over your mistakes Draw a single line through the mistake and write “error” above it Just leave the mistake because no one will notice it Cover up the mistake with a black felt pen

6. When reporting a change in the client's condition you need to tell the supervisor all of the following EXCEPT: *

Exactly what has changed about the client Any changes in the client's behavior (appetite, sleeping, habits, etc.) Any complaints or problems the client has expressed (pain, stress, etc.) Why you are late today

7. You should write a note in the daily care record at least: *

Weekly Every shift Every few days Hourly

Infection Control

8. Good hand-washing technique is important because: *

It is required by the health department It prevents the spread of germs It is good for the client's morale It is required by my children and spouse

9. Wearing disposable gloves while changing bed linen: *

Means your client has an incurable disease Boosts my fashion dress sense Is never necessary unless the client has AIDS Protects you and your client from the spread of germs

10. When handling dirty linen and clothes, it is best to: *

Shake linen and clothing before you wash them Place dirty linens and clothing in a clothes hamper or plastic bag until they can be washed Sniff your clothes then wear them back on Put the dirty linen and clothes on the floor

11. When cleaning up a spill that possibly contains blood, you should: *

Wear gloves Dispose of paper towels in a plastic bag and seal it Use soap and water followed by bleach solution or other approved disinfectants All of the above

12. When considering the homemaker's role in reducing the spread of germs, the homemaker would do all of the following EXCEPT: *

Go to work even when you are ill To protect yourself, clean and cover cuts Cover nose and mouth while sneezing or coughing Wash hands after handling soiled items such as linens, clothing, garbage, etc.

Housekeeping Skills

13. The role of the homemaker is to provide support measures such as: *

Preparing meals Housekeeping duties Taking blood pressure A and B only

14. The client's bedroom has a polished hardwood floor. Which is the best method of daily cleaning? *

Don't clean it at all Sweep it with a stiff bristle brush Mop it with a dust mop Scrub it with a strong detergent

15. Immediately after washing dishes in hot soapy water they should be: *

Dried Boiled for 5 minutes Put away in a cupboard Rinsed with hot water and dried

16. In preparing a meal, you accidentally break a clean dish. After cleaning up the broken pieces you should: *

Continue your shift and forget about it Buy a new dish, replace it and tell the client Call the police or the FBI to report it Tie and glue the dish back together and put it back without telling the client

17. All of the following activities are what a homemaker should routinely perform, EXCEPT: *

Cleaning the kitchen sink Vacuuming the carpets Rearranging the furniture Changing the client's bed linen

Maintenance of a Safe and Healthy Environment

18. Wrinkles in the client's bed linen may cause: *

No problems Bedsores The linen to wear out Contractures

19. Which one of the following statements is NOT true? *

If someone in the house uses a cane or walker, it is a good idea to cushion the floor by using lots of throw rugs Puddles of water or other liquids should be mopped up immediately to avoid falls Cleaning supplies and other dangerous substances should be kept in a safe, secure cabinet area Always be sure electrical cords are not lying in walk areas

20. When caring for a client where there are children in the home, which of the following would be dangerous? *

Dusting the living room furniture Keeping the clean bedpan next to the bed Washing the kitchen floor Keeping medication bottles next to the bed

21. You discover cockroaches in the client's home. You should: *

Remove the client from the home Make sure to remove garbage daily Call the office to report the situation Both B and C

22. To prevent fires in the home, which of the following is NOT correct? *

Never use frayed electrical cords Have a smoke detector on each level of the house Never leave a frying pan containing oil unattended and cooking on the stove Have a house without carpet floors

Recognizing Emergencies and Knowledge of Emergency Policies

23. Mrs. Angel lives alone and is homebound. When you arrive, 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 hear a low moan coming from somewhere in the house. You should: *

Come back at your next scheduled shift or visit Knock until she opens the door Get to the nearest telephone and call the office Break a window and climb in

24. Fire safety instruction is important because: *

The supervisor says it is It will look good on your record The client will think you are great It prepares you to know proper emergency actions in case of fire

25. While cooking dinner you accidentally spill boiling water on your hand. You should: *

Cover the area with Vaseline or butter Apply cold water to the area, if there is no break in the skin Scold the patient for being in the kitchen Put on a hat and go to sleep

26. A stranger comes to the door claiming that their car broke down and asks to use the phone. You should: *

Go out to the car and see if you can fix the problem Let them into the house and call the tow truck for them Not allow them into the house, but offer to help them call the police Let them into the house to use the telephone

27. Your client suddenly complains of intense squeezing pain in the chest that goes down his arm. The client is sweating and holding his chest. You should: *

Leave a message with the doctor's office Have the client take a nap Telephone for emergency help, 911 Ignore him — it will go away

Physical, Emotional and Developmental Needs for Privacy and Property

28. The client offers you money. You should: *

Take it and politely say “Thank you” Refuse the money and tell the client you are not allowed to accept gifts Consider it a loan that you will pay back Take it because you need the cash

29. Wrinkles in the client's bed linen may cause: *

Bedsores Contractures No problem The linen to wear out

30. In which of the following situations would the homemaker be held responsible for damages caused by a broken lamp in a client's home? *

The client turned quickly while waving his arms and tipped the lamp over The client's dog bumped the table, knocking over the lamp The homemaker knocked over the lamp while vacuuming The client's wife knocked over the lamp while showing the homemaker where the outlet was located

31. A client named Ms. Green tells you she is very upset with you and demands the supervisor she can call to report you. The correct action is: *

Argue with her and defend yourself aggressively Ignore her complaint and walk away Politely provide her with the supervisor's contact information and offer to assist in addressing her concerns Tell her that complaints are not allowed and refuse to give any information

32. You are caring for Mrs. Jones, a terminally ill client. A neighbor stops by and asks if Mrs. Jones is going to die. You should reply: *

By sharing the details about Mrs. Jones' condition since the neighbor is concerned By ignoring the neighbor and walking away without responding By politely explaining that you cannot share private health information and suggesting they speak with Mrs. Jones or her family By telling the neighbor that Mrs. Jones doesn't have much time left

33. When caring for a client who is from a culture different from yours, remember that: *

The client lives in the United States now and should change their ways to conform to our culture The client's response of grief and pain should be the same as yours Family habits and religious practices will affect the way the client responds to the care you provide All people are the same

Nutrition and Meal Preparation

34. Elderly people may not eat a well-balanced diet due to: *

Their natural preference for junk food over healthy meals Their body's reduced need for nutrients as they age Decreased appetite, difficulty chewing or swallowing, financial limitations, or limited access to nutritious food A universal dislike for cooking or preparing meals

35. The best example of a low-fat breakfast is: *

Fried bacon, scrambled eggs, and buttered toast Sausage, hash browns, and a biscuit with gravy Oatmeal with fresh fruit and a glass of skim milk A donut with a large caramel latte

36. Very good sources of protein are: *

Green salads Apples and oranges Beans, chicken and eggs Potatoes and noodles

37. Which of the following statements is correct? *

Clients must always eat at 12 noon All food served to the patient should be lukewarm The client must always be fed and is not allowed to feed themselves Before serving the meal, it is important to be sure the patient is comfortable

38. It would be UNSAFE to: *

Cook meat well done Wrap food before refrigerating Refreeze food that has been frozen and thawed Thaw turkey in the refrigerator

39. You can use communication skills when: *

Explaining your duties to the patient Writing your daily care notes Reporting changes to the supervisor All of the above

40. Communication includes: *

Listening Spoken word Facial expressions All of the above

41. If a client is having a hard time hearing, you should: *

Speak slowly and clearly Avoid talking to them Use sign language Shout at them

42. Your client has expressed a religious belief you do not agree with. You should: *

Pretend you agree Listen respectfully Explain how your beliefs are much better Tell them they are wrong

43. Ways to foster communication include all EXCEPT: *

Listen carefully Speak slowly and clearly Avoid using a lot of medical terms Interrupting often

Bonus Questions — True or False

44. A homemaker or caregiver should always treat clients with dignity and respect, regardless of their condition or behavior. *

True False

45. A caregiver should always administer medication to a client when they request it, even if it is not part of the care plan. *

True False

46. A caregiver should always protect a client's privacy and maintain confidentiality about their personal and medical information. *

True False

47. It's acceptable to share a client's personal information with their neighbor if the neighbor is concerned. *

True False

48. It is okay to leave a client unattended for long periods if they are sleeping. *

True False

49. Proper handwashing before and after providing care helps prevent the spread of infections. *

True False

50. If a client refuses care, the caregiver should force them to comply for their own safety. *

True False

Consent

Yes, I agree with the privacy policy and terms and conditions, and I confirm that the information and electronic signatures I have provided are true and accurate. *

All required fields and signatures must be completed before submitting.

Time-Off Request

Employee Name *

Position

Start Date *

End Date *

Type

Coverage arranged?

Supervisor

Date Submitted

Reason / Notes

I understand this request is subject to approval.

Your details are kept private and used only to respond to you.

This curriculum fulfills the State of Illinois 24-hour pre-service training requirement for home care aides. Please read each topic carefully. After reviewing all modules, complete the acknowledgment and sign below.
Total: 24.00 training hours

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 HRS

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

Personal Care, Bathing, Dressing and Toileting

1 HR

Personal Care

Personal Care: Hair, Skin, Nall, Dental and Shaving Care

1 HR

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

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 HRS

Hygiene, Infection Control, Infectious Diseases, Influenza

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 HRS

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.

HIPAA 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

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

Respiratory Services and Cardiovascular Systems

1.5 HRS

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 HRS

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 HRS

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 HRS

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 HRS

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 HRS

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.

Acknowledgment of Completion

Employee Name *

Presenter / Supervisor

Employee Signature *

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Date *

Yes, I agree with the privacy policy and terms and conditions. *

Please complete your name, signature, date, and consent.