Home Care Checklist Business/Services Provided

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The following list of questions should encompass most care questions that need to be asked when seeking home care. It is meant as a guide to help one find good, quality, dependable home care when appropriate. Business/Services Provided How long has your agency been in business? What is the background/experience of the owner? Does the agency have satisfied, long-term employees? Yes Does the agency have a fully staffed office? Yes Can I interview the caregiver before accepting care? Yes How do I know I can trust your employees? Do your employees smoke? Yes Will your employee call before arriving? Yes Is caregiver reliability guaranteed in writing? Yes Does the agency have an automated telephone time card system to alert supervisors if a caregiver arrives late or leaves early? Yes Is a personalized plan of care developed with me during the assessment? Yes Is the care plan reviewed and updated with regularity? Yes Does this plan of care include goals and expected outcomes? Yes Does the agency coordinate care with other healthcare services? Yes Do you provide temporary as well as long-term assistance? Yes 1777 N. California Blvd. Suite 210 Walnut Creek, CA 94596 925-933-8181 serviceinquiry@hillendale.net www.hillendale.net

Does the agency have the capacity to accommodate a full range of home care needs from light duty companion care to heavy care, including end of life care? Yes What kind of care is provided? Nursing care n-medical care Personal care Chore Companionship What happens if I need different tasks done each week? How many hours is a minimum shift? How many hours is a maximum shift? Can a shift be split (e.g., two hours in the morning and two in the evening)? Yes How soon could your care start? Is assistance on a weekend available? Yes Are there any restrictions against accompanying the client outside the home or driving a car? Yes Are home care workers agency employees (with benefits and insurance)? Yes Or contractors (e.g., private individuals on a referral registry)? Yes Is your agency bonded (insured against theft)? Yes Are the workers who come into the home bonded? Yes Do you have proof of liability coverage? Yes If I need a ride to a doctor appointment or shopping, is there insurance coverage for that? Yes Is the agency licensed or certified (if required in your state)? Yes Is the agency a member of any professional organizations? Yes If yes, which? How are caregivers assigned? Is/are the caregiver(s) available for emergencies and/or on short notice? Yes Are they available on holidays? Yes Will I be able to indicate preferences for the type of caregiver I would like? (For example, male/female, non-smoking, etc.) Yes Hillendale Home Care 925-933-8181 www.hillendale.net Page 2

Caregiver Qualifications (Training, Licensing, Background Checks) Are all your home care workers licensed or certified? Yes If not, what minimum qualifications do workers have? Do you require that your employees renew their state licenses (if appropriate), keeping them current? Yes Do you screen your workers? Yes If so, what type of background checking is done? What are the qualifications of the person who will do my initial assessment? How long have each of your staff been employed with this company? Does the agency require yearly physicals/tb tests, drug and alcohol screening and CPR training? Yes Do caregivers receive a thorough orientation by a supervisor on safety issues, agency procedures, and care goals and standards before placement? Yes Do caregivers write daily care notes with a copy left for the client and eligible family members? Yes Are care notes reviewed regularly? Yes Does the agency have a quality care program to ensure the highest standards of care? Yes Are workers trained, and is training ongoing? If so, does the training include: Safe bending and lifting practices? Yes CPR/first aid? Yes Infection control? Yes Managing incontinence? Yes Catheter care? Yes Communicating with someone who is confused or forgetful? Yes Managing difficult behaviors (e.g. wandering, paranoia, or memory loss)? Yes Bathing someone in the tub/shower or in bed? Yes Preserving client dignity? Yes Is/are the caregiver(s) experienced in any special services? Yes Can the caregiver(s) speak languages other than English, if needed? Yes Can you furnish references for your workers that I can check? If not, do you have any client satisfaction survey results you can share with me? Yes Hillendale Home Care 925-933-8181 www.hillendale.net Page 3

Service Quality Are workers supervised? Yes If so, by whom? Is there a written care plan specifying the home care worker s routine duties? Yes If so, can the family have a copy? Yes How often is the plan updated? Do the elder (and involved family members) have input into the client service plan? Yes Do you arrange regular conversations with the family about the client s case? Yes Will a supervisor visit or call the client s home? Yes To whom can the client or family ask questions or make complaints? How do you ensure your clients confidentiality? How does the agency follow up on/resolve problems or complaints? Can a known agency worker be requested by name? Yes Can a different worker be requested, if there was a problem with the first one? Yes How fast can your agency respond to an emergency need? Are workers available 24 hours, 7 days a week? Yes Is there always someone available at your office to take a call? Yes Can a replacement worker be called if the worker does not come or cannot complete a shift? Yes If so, how long does it usually take to get a replacement? Hillendale Home Care 925-933-8181 www.hillendale.net Page 4

Financing/Payment Do you accept private health care or long-term care insurance? Yes Does the agency pay the worker s Social Security and taxes? Yes If not, do I need to pay this? Yes What is the cost for overtime, if the worker stays late? When is payment due? (e.g. at the end of each visit? Weekly? Monthly?) Does payment go to the agency? Yes Or the home care worker directly? Yes Are there any additional costs for travel time or extra services (e.g. doing laundry or errands)? Yes Are all costs and fees listed on a written statement? Yes What is your initial registration fee? Do you charge for the initial assessment? Yes Do you charge any other upfront fees or administrative costs? Yes Do you have a reassessment fee? Yes What is the hourly or daily charge for one person? For a couple? Do you charge mileage to and from my home? Yes Do you charge for staff time to and from my home? Yes What is the mileage charge for trips to the doctor or shopping? Are there extra fees for some of the services I might require? Yes If yes, how much are they? Are bills itemized? Yes Are payment plan options provided? Yes Do you assist with billing my insurance company for home care? Yes Hillendale Home Care 925-933-8181 www.hillendale.net Page 5