Common use of Personal Care Clause in Contracts

Personal Care. ❑ Assist with transfers from chairs, bath, etc. ❑ Assist with bathing ❑ Assist with toileting ❑ Assist with dressing ❑ Assist with walking ❑ Assist with exercises ❑ Assist with personal grooming ❑ Observe and record any health or behavior changes Meals and Nutrition ❑ Plan ___ meals and ___ snacks a day ❑ Prepare and serve food ❑ Assist with feeding ❑ Clean, dry and put away dishes ❑ Wipe counters and stove ❑ Grocery shopping General Duties ❑ Clean bathtub, toilet and sink ❑ Empty trash cans and take out garbage ❑ Sort recycling items ❑ Care for pets ❑ Wash, dry, fold and put away laundry ❑ Vacuum carpets and sweep floors ❑ General dusting & cleaning of home surfaces ❑ Secure home when leaving ❑ Water plants and/or maintain garden ❑ Shovel and/or de-ice steps Health Care These services should be provided by a licensed therapist or nurse. It is advised to see a current license and make a copy. ❑ Speech therapy ❑ Wound care or bandaging ❑ Rehabilitative or therapeutic physical ❑ Occupational therapy ❑ Medication prompting Providing Transportation* ❑ Employee will be provided a vehicle ❑ Beauty or personal care ❑ Social visits to family and friends ❑ Medical and dental appointments ❑ Arranging for alternative transportation ❑ Faith-based events * If a vehicle is not provided, any miles driven while on the clock using the employee’s car will be reimbursed and the IRS Mileage Reimbursement Rate of 57.5 cents per mile. This covers the cost of gasoline, as well as general wear and tear on the vehicle. Employee will maintain and mileage log and submit to employer for reimbursement at the end of the pay period. Additional timelines and instructions are attached in the Home Care Rules and Daily Schedule NOTES ABOUT THE PERSON RECEIVING CARE The person you will care for, _________________________, ❑ can ❑ cannot be left alone and has been diagnosed with _______________________________________. This can cause these changes in his/her behavior: _____________________________________________________________________________ _____________________________________________________________________________________ Please include any essential information about dementia, Alzheimer’s, food allergies, chronic pain, or other conditions.

Personal Care. ❑ Assist with transfers from chairs, bath, etc. ❑ Assist with bathing ❑ Assist with toileting ❑ Assist with dressing ❑ Assist with walking ❑ Assist with exercises ❑ Assist with personal grooming ❑ Observe and record any health or behavior changes Meals and Nutrition ❑ Plan ___ meals and ___ snacks a day ❑ Prepare and serve food ❑ Assist with feeding ❑ Clean, dry and put away dishes ❑ Wipe counters and stove ❑ Grocery shopping General Duties ❑ Clean bathtub, toilet and sink ❑ Empty trash cans and take out garbage ❑ Sort recycling items ❑ Care for pets ❑ Wash, dry, fold and put away laundry ❑ Vacuum carpets and sweep floors ❑ General dusting & cleaning of home surfaces ❑ Secure home when leaving ❑ Water plants and/or maintain garden ❑ Shovel and/or de-ice steps Health Care These services should be provided by a licensed therapist or nurse. It is advised to see a current license and make a copy. ❑ Speech therapy ❑ Wound care or bandaging ❑ Rehabilitative or therapeutic physical ❑ Occupational therapy ❑ Medication prompting Providing Transportation* ❑ Employee will be provided a vehicle ❑ Beauty or personal care ❑ Social visits to family and friends ❑ Medical and dental appointments ❑ Arranging for alternative transportation ❑ Faith-based events * If a vehicle is not provided, any miles driven while on the clock using the employee’s car will be reimbursed and the IRS Mileage Reimbursement Rate of 57.5 56 cents per mile. This covers the cost of gasoline, as well as general wear and tear on the vehicle. Employee will maintain and mileage log and submit to employer for reimbursement at the end of the pay period. Additional timelines and instructions are attached in the Home Senior Care Rules and Daily Schedule NOTES ABOUT THE PERSON RECEIVING CARE The person you will care for, _________________________, ❑ can ❑ cannot be left alone and has been diagnosed with _______________________________________. This can cause these changes in his/her behavior: _____________________________________________________________________________ _____________________________________________________________________________________ Please include any essential information about dementia, Alzheimer’s, food allergies, chronic pain, or other conditions.Schedule

Personal Care. ❑ Assist with transfers from chairs, bath, etc. ❑ Assist with bathing ❑ Assist with toileting ❑ Assist with dressing ❑ Assist with walking ❑ Assist with exercises ❑ Assist with personal grooming ❑ Observe and record any health or behavior changes Meals and Nutrition ❑ Plan ___ meals and ___ snacks a day ❑ Prepare and serve food ❑ Assist with feeding ❑ Clean, dry and put away dishes ❑ Wipe counters and stove ❑ Grocery shopping General Duties ❑ Clean bathtub, toilet and sink ❑ Empty trash cans and take out garbage ❑ Sort recycling items ❑ Care for pets ❑ Wash, dry, fold and put away laundry ❑ Vacuum carpets and sweep floors ❑ General dusting & cleaning of home surfaces ❑ Secure home when leaving ❑ Water plants and/or maintain garden ❑ Shovel and/or de-ice steps Health Care These services should be provided by a licensed therapist or nurse. It is advised to see a current license and make a copy. ❑ Speech therapy ❑ Wound care or bandaging ❑ Rehabilitative or therapeutic physical ❑ Occupational therapy ❑ Medication prompting Providing Transportation* ❑ Employee will be provided a vehicle ❑ Beauty or personal care ❑ Social visits to family and friends ❑ Medical and dental appointments ❑ Arranging for alternative transportation ❑ Faith-based events * If a vehicle is not provided, any miles driven while on the clock using the employee’s car will be reimbursed and at the IRS Mileage Reimbursement Rate of 57.5 58.5 cents per mile. This covers the cost of gasoline, as well as general wear and tear on the vehicle. Employee will maintain and mileage log and submit to employer for reimbursement at the end of the pay period. Additional timelines and instructions are attached in the Home Senior Care Rules and Daily Schedule NOTES ABOUT THE PERSON RECEIVING CARE The person you will care for, _________________________, ❑ can ❑ cannot be left alone and has been diagnosed with _______________________________________. This can cause these changes in his/her behavior: _____________________________________________________________________________ _____________________________________________________________________________________ Please include any essential information about dementia, Alzheimer’s, food allergies, chronic pain, or other conditions.Schedule

Personal Care. ❑ Assist with transfers from chairs, bath, etc. ❑ Assist with bathing ❑ Assist with toileting ❑ Assist with dressing ❑ Assist with walking ❑ Assist with exercises ❑ Assist with personal grooming ❑ Observe and record any health or behavior changes Meals and Nutrition ❑ Plan ___ meals and ___ snacks a day ❑ Prepare and serve food ❑ Assist with feeding ❑ Clean, dry and put away dishes ❑ Wipe counters and stove ❑ Grocery shopping General Duties ❑ Clean bathtub, toilet and sink ❑ Empty trash cans and take out garbage ❑ Sort recycling items ❑ Care for pets ❑ Wash, dry, fold and put away laundry ❑ Vacuum carpets and sweep floors ❑ General dusting & cleaning of home surfaces ❑ Secure home when leaving ❑ Water plants and/or maintain garden ❑ Shovel and/or de-ice steps Health Care These services should be provided by a licensed therapist or nurse. It is advised to see a current license and make a copy. ❑ Speech therapy ❑ Wound care or bandaging ❑ Rehabilitative or therapeutic physical ❑ Occupational therapy ❑ Medication prompting Providing Transportation* ❑ Employee will be provided a vehicle ❑ Beauty or personal care ❑ Social visits to family and friends ❑ Medical and dental appointments ❑ Arranging for alternative transportation ❑ Faith-based events * If a vehicle is not provided, any miles driven while on the clock using the employee’s car will be reimbursed and the IRS Mileage Reimbursement Rate of 57.5 cents per mile. This covers the cost of gasoline, as well as general wear and tear on the vehicle. Employee will maintain and mileage log and submit to employer for reimbursement at the end of the pay period. Additional timelines and instructions are attached in the Home Senior Care Rules and Daily Schedule NOTES ABOUT THE PERSON RECEIVING CARE The person you will care for, _________________________, ❑ can ❑ cannot be left alone and has been diagnosed with _______________________________________. This can cause these changes in his/her behavior: _____________________________________________________________________________ _____________________________________________________________________________________ Please include any essential information about dementia, Alzheimer’s, food allergies, chronic pain, or other conditions.Schedule