| FORM NAME |
| Authorization to Release PHI |
| Automobile Use Waiver Agreement |
| Auto-Payment Authorization Form |
| Bladder and Bowel Log Forms |
| Bomb Threat Checklist |
| Caregiver Acknowledgement of Care Plan |
| Caregiver Interview Questionnaire - Master Template |
| Caregiver Notes-Client Daily Record |
| Caregiver Notes-Weekly Notes |
| Client Assessment Service Plan & Face Sheet |
| Client Consent for Referral & Release of Information |
| Client Coordination of Care Checklist |
| Client Flow Chart |
| Client Home Chart - Template |
| Client Insurance Information |
| Client Invoice - Individual MSWord |
| Client Invoice - Master Log MSWord |
| Client Medication Record |
| Client Observation Diagram |
| Client Recurring Payment Authorization Form |
| Client Satisfaction Questionnaire |
| Client Satisfaction with Implemented Services |
| Client Service Agreement & Fee Schedule |
| Client Service Certification Record |
| Client Service Plan & Face Sheet |
| Client Service Schedule |
| Client Valuables Record |
| Communication with People With Disabilities |
| Competency Assessment Form - HCA Initial |
| Competency Test - Answers & Composition |
| Competency Test - Practical Skills |
| Competency Test - Written Questions |
| Complaint & Grievance Form |
| Confidential Payroll Information |
| Confidentiality/Non-Disclosure Agreement |
| Conflict of Interest Statement |
| Consent to Release Information – Client |
| Consent to Release Information – Employee |
| COVID-19 Declination Form |
| COVID-19 Employee Notice |
| COVID-19 Screening Tool - Return-to-Work |
| DE4 - California Employee's Withholding Allowance Certificate |
| Declination of Influenza Vaccination |
| Direct Deposit Authorization |
| Discharge or Transfer - Client Notification Form |
| Discharge or Transfer - Summary |
| Emergency Phone Numbers - Client |
| Emergency Preparedness Plan |
| Employee Contact Information |
| Employee Mileage Record |
| Employee Performance Appraisal - Annual |
| Employee Performance Appraisal - Supervisory Visit |
| Employment Agreement California Personal Care Attendant |
| Employment Application |
| Employment Candidate Interview |
| Fall Risk Assessment Form - Master Template |
| Financial Transactions Record |
| Grocery List |
| HCA Introduction - Training & Skills Checklist |
| HCS 500 REGISTERED HOME CARE AIDE TRAINING LOG |
| HCS 501 PERSONNEL RECORD |
| HCS 9201 Inspection Checklist |
| Hepatitis B (HBV) Consent/Waiver Form |
| Hepatitis B (HBV) General FACT SHEET |
| Home Safety Checklist |
| I.01.Incident Report-Binder Cover |
| I.02.Incident Report - Index |
| I.03.Incident Reporting Log |
| I.04.Incident Report - General |
| I.05.Incident Report: COVID-19 |
| I.06.Incident Report - Medication |
| I.07.Incident Report - Post Exposure to Blood-borne Diseases |
| I.08.Incident Report - Post Exposure to Tuberculosis |
| I-9 Employment Eligibility Verification - Binder Cover |
| I-9 Employment Eligibility Verification - Form |
| I-9 Employment Eligibility Verification - SIDE TAB |
| Identity Theft Prevention Program & Addendums |
| Job Description - Template |
| LIC 9163 LIVE SCAN FORM |
| LIC 9188 CRIMINAL RECORD EXEMPTION TRANSFER REQUEST |
| LIC301E Reference Request |
| Medication Log |
| Notice of Privacy Practices |
| Notice of Receipt - NPP - Acknowledgment |
| Notice to Employee - Labor Code LC 2810.5 |
| Notification of Affiliated Home Care Aide Status - Agency Employee |
| Orientation Checklist |
| Orientation Sign in Form |
| Paid Family Leave Brochure de2511 |
| Payment Agreement |
| Personal/Private Vehicle Mileage Form |
| Personnel Record Contents - Checklist |
| Personnel Record Inspection Log |
| Policy & Procedure Change Tracking Form |
| Pre-Adverse Action Notice |
| Pre-Adverse pdf-0096-fair-credit-reporting-act |
| Pre-Employment Background Check Authorization |
| Private-Direct Hiring of HCA Agreement |
| QAPI - Quality Assessment & Performance Improvement Plan |
| Reference Check Authorization |
| Reference Check Form X2 |
| Referral Intake Form |
| Client Release of Liability – Transportationr |
| Return of Company Property Agreement |
| Rights & Responsibilities of Client & Organization |
| Sexual Harassment - The Facts About Sexual Harassment |
| SOC 341 REPORT SUSPECTED DEPENDENT ADULT/ELDER |
| SOC 341A REPORT SUSPECTED ABUSE ACKNOWLEDGMENT |
| Staff Record of Training |
| Standards of Conduct |
| Time of Hire Pamphlet - MSWord |
| Time of Hire Pamphlet - Workers' Compensation |
| trs_earnedsickleavenotice Poster |
| W-4 - IRS Employee's Withholding Allowance Certificate |