Personal Information

*Please fill the email ID correctly for successful submission

Self-Assessed experience rating scale

1 = No experience

2 = Limited Experience

3 = Experienced

4 = Highly Skilled

Provide male perineal care

Provide female perineal care

Provide oral care

Provide oral care for unconscious resident

Provide denture care

Provide hair care

Shave the resident

Provide nail care to non-diabetics

Provide foot care to non-diabetics

Provide skin checks/Heel and elbow protectors

Provide dressing/undressing assistance

Apply compression support stockings

Make unoccupied bed

Make occupied bed

Provide tub, whirlpool, or shower assistance

Provide complete bed bath

Provide backrub

Perform/record manual and digital blood pressure

Measure/record manual and digital pulse

Measure/record pain

Measure/record respirations

Measure/record temperature with glass or digital thermometers

Measure/record height

Measure/record weight

I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct.