Personal Information

*Please fill the email ID correctly for successful submission

Home Health Aid Self Rating

A = I can perform well

B = I need to review

C = I have no experience

Skills

Communication

Observation, reporting and documentation of patient status and the care of services provided

Reading and recording temperature, pulse and respiration

Universal Precautions

Basic elements of body functions and changes in condition that must be reported

Maintaining a clean, safe and health environment

Ability to recognize emergency situations

Ability to recognize physical and emotional needs and work with the client and respect the pt’s privacy and property

Bed Bath

Sponge Bath

Shampoo (sink, tub or bed)

Nail Care

Skin Care

Oral Hygiene

Toileting and elimination

Safe transfer techniques

Safe Ambulation

Normal positioning with proper body alignment

Ability to recognize adequate nutrition and intake

I certify that all the above information is correct, and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from the agency. I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct.

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Contacts

+1 781 645 7072

2021 Guadalupe Street Suite 260 Austin,
Texas 78705 United States of America

info@tricehealthcare.com marketing@tricehealthcare.com

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