A 4-page Word weekly timesheet for caregivers to record visit hours, travel time, and other paid time.

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

What’s included

1. Page 1: employee, workweek, pay period, and a daily log by client (visit hours, unpaid meal, travel between clients, work miles, visit-verification boxes and exception codes)
2. Page 2: weekly totals A-H (visit, travel, training, other work time, total, regular, weekly overtime, state daily overtime) with employee and supervisor sign-off
3. Page 3: client / representative visit verification (one page per client)
4. Page 4: payroll calculation worksheet (regular, overtime, paid leave, other wages)
5. 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. This timesheet records time; it does not decide pay rules. Check federal and state wage and hour rules and your payer’s visit-verification rules.