HHA/PCA Orientation Packet
Name
*
First Name
Last Name
Mobile Phone Number
*
Email
*
Title:
*
PCA
HHA
Please review the following:
*
I agree to comply with the agency’s policies and procedures. I understand and agree with it in its entirety.
I have received a copy of my job description.
I have received my photo ID
Employee Signature
*
Competency Skills
Infection Control
*
Proper hand washing technique
Techniques for putting on and taking off gloves and masks and properly disposing of same
Proper disposal of infectious and / or hazardous materials
Assessing/reporting changes in skin condition, including pressure ulcers
Transferring
*
Bed to wheelchair
Wheelchair to bed
Positioning
*
Client in bed
Client in wheelchair
Body Mechanics
*
During transfers
Bending
Lifting
Carrying a heavy object
Assisting with Ambulation
*
With no device
With walker
With cane
With crutches
Bedmaking
*
Empty bed
With bed-bound patient
Safe Use of Equipment
*
Understands how to check each type of equipment for proper functioning
Does HHA know proper procedure to remedy malfunctioning equipment?
TPR - Where do you insert or measure:
*
Thermometer
Pulse
Respirations
How do you:
*
Read the thermometer
Count the pulse
Count the respirations
How do you record:
*
Temperature
Pulse
Respirations
RN Signature
*
RN Signature Date
/
Month
/
Day
Year
Office Use Only
Submit
Reply to email
Date
/
Month
/
Day
Year
Date
Should be Empty: