A 3-page Word checklist to track each new caregiver from offer to the 90-day check-in.

For USA non-medical home care agency owners, HR staff, and supervisors. Plus 1 agency instructions page to remove before use.

What’s included

1. Page 1: employee details and Phase 1 pre-start paperwork and screening (offer letter, I-9, W-4, handbook, and more) with date and initials
2. Page 2: Phase 2 orientation and training topics (client rights, abuse reporting, confidentiality, infection control, emergencies, body mechanics, medication reminders only, timekeeping, and state topics)
3. Page 3: Phase 3 first shift, pay setup, uniform, and equipment, and Phase 4 30 / 60 / 90-day check-ins and recurring dates
4. Agency instructions page, to remove before use

Add your logo and name

1. Open the Word file and replace the Your Logo Here box with your logo.
2. Replace Agency Name in the letterhead; the body says “the Agency,” so no other name edits are needed.
3. Replace the Street Address, City, State ZIP line and the Phone, Email, Website line with your details.
4. Set the letterhead text to black, delete the instructions page, and save.

Customizable template, not legal advice; check your state’s requirements. Not a license to operate, not HIPAA software, and no medical claims. The checklist records that a step was done. Adapt the steps to federal and state rules for your agency. Not legal advice.