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    HRHC Timesheet 2022

    Uploaded by

    aysiahaynes32

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    HRHC Timesheet 2022

    Uploaded by

    aysiahaynes32
    3 views1 page

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3 views1 page

    HRHC Timesheet 2022

    Uploaded by

    aysiahaynes32

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    Weekly Time Sheet COVID Q4.

    COVID Q4. Has the consumer had any fever, chills, cough, difficulty breathing, sore
    throat, muscle aches, diarrhea, severe fatigue, nasal congestion, loss of sense of
    Weekending Date: ___/___/______
    09 09 2024
    (ALWAYS SUNDAY) taste/smell in the last 24 hours?
    Scope of Service Record
    EMPLOYEE NAME: ______________________________________
    Aysia haynes Directions: This is considered a legal document. Please check the care plan. Check each activity
    CONSUMER NAME: _____________________________________ that is completed. Indicate “R” if an assigned activity was refused by the consumer. Indicate “H” for
    Nadira patterson
    hospitalizations. Reminder all consumer changes including hospitalizations should be called into
    CONSUMER ADDRESS: __________________________________
    630 s 54th street the office IMMEDIATELY, (215)248-3300.

    MONTH OF: MON TUES WED THURS FRI SAT SUN ACTIVITY/DAY Mon Tues Wed Thurs Fri Sat Sun
    DATE: Meal Prep Circle
    B L D SNACK
    SHIFT Time in:
    ONE
    9:00 9:00 9:00 9:00 9:00 9:00 Feeding
    Time Out: 2:00 pm 2:00 2:00 2:00 2:00 2:00
    SHIFT Time in: Incontinency Care
    TWO Time Out: Sponge Bath
    SHIFT Time in:
    THREE Time Out: Shower Bath
    TOTAL: Mouth Care
    WEEKLY TOTAL HOURS: __________
    35 Hair Care
    COVID Q1. Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Dressing
    COVID Q2. Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No
    Shaving
    COVID Q3. Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No
    COVID Q4. Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Circle: Yes/No Toileting
    If "YES", you will need to contact the office. Assist with walking
    CONSUMER NOTE: By your signature, you certify that the hours shown are true and accurate, and work was Help with Walker
    completed satisfactorily for the days and times documented. Help with wheelchair
    CONSUMER SIGNATURE: ___________________________________________________ Transfers w/o hoyer
    Hoyer Lift Transfer
    EMPLOYEE NOTE: By your signature, you certify that the hours recorded for the above dates are true and
    accurate and are properly verified by the client.
    Escort
    Maintain Commode
    09/09/24 Living Room Vac/Dust
    EMPLOYEE SIGNATURE DATE Dining Room Vac/Dust
    *Timesheets are due by 12 p.m. Tuesday. Please drop off, or email to timesheets@hoperisinghomecare.com Bedroom Vac/Dust
    If timesheets arrives after deadline you will not be paid until the following week. EVV Telephone Number
    Dishes and Cleanup
    844-759-0692-
    COVID Q1. To your knowledge, in the past two weeks have you had close contact with Kitchen Floor/APPL
    someone currently diagnosed with Covid-19? Bed Change
    COVID Q2. Have you had any fever, chills, cough, difficulty breathing, sore throat, Laundry
    muscle aches, diarrhea, severe fatigue, nasal congestion, loss of sense of taste/smell in Bathroom
    the last 24 hours? Errands
    COVID Q3. To your knowledge, in the past two weeks, has the consumer had close Trash Removal
    contact with someone currently diagnosed with Covid-19? Other

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