HHA/PCA Orientation Packet
Name
*
First Name
Last Name
Email
*
Phone Number
Please enter a valid phone number.
Format: 0000000000.
Mobile Phone Number
*
Office you applied in:
*
Please Select
Bay Shore
Elmhurst
Staten Island
Hicksville
Title:
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HHA
PCA
Please review the following:
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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
*
Office Use Only
Competency Skills
Infection Control
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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
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Bed to wheelchair
Wheelchair to bed
Positioning
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Client in bed
Client in wheelchair
Body Mechanics
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During transfers
Bending
Lifting
Carrying a heavy object
Assisting with Ambulation
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With no device
With walker
With cane
With crutches
Bedmaking
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Empty bed
With bed-bound patient
Safe Use of Equipment
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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:
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Thermometer
Pulse
Respirations
How do you:
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Read the thermometer
Count the pulse
Count the respirations
How do you record:
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Temperature
Pulse
Respirations
RN Signature
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RN Signature Date
/
Month
/
Day
Year
Student ID
Submit
Reply to email
Date
/
Month
/
Day
Year
Date
Should be Empty: