TABLE OF CONTENTS:

1. COMPANY DESCRIPTION 

1.1 INTRODUCTORY STATEMENT 
1.2. LOCATION OF COMPANY 
1.3. COMPANY OBJECTIVES 
1.4. BUSINESS LIABILITY INSURANCE (DELETE IF THIS SECTION DOES NOT APPLY) 
1.5. COMPANY HOURS OF OPERATION: NON-MEDICAL HOME CARE SERVICES OLDER ADULTS 

2. TYPES OF NON-MEDICAL AGENCY SERVICES

3. DESCRIPTION OF NON-MEDICAL AGENCY SERVICES: 

3.1. CARE PLANNING AND COORDINATION 
3.2. RESPITE SERVICE FOR PRIMARY CAREGIVERS 
3.3. COMPANION CARE 
3.4. MOBILITY/ AMBULATION ASSISTANCE 
3.5. PERSONAL CARE SERVICES 
3.6. SOCIAL CARE & TECH ASSISTANCE 
3.7. NON-MEDICAL TRANSPORTATION 
3.8. TRANSITIONAL CARE SERVICES 
3.9. FALL PREVENTION SERVICES 
3.10. GENERAL HOME MANAGEMENT 
3.11. HOUSEKEEPING 
3.12. MEAL PLANNING & PREPARATION SERVICE 
3.13. CLIENT SELF-ADMINISTRATION OF MEDICATION POLICY 

4. STATE & FEDERAL COMPLIANCE WITH LAWS AND REGULATIONS 

4.1 [ENTER STATE] APPLICABLE LAWS AND REGULATIONS FOR NON-MEDICAL AGENCY PROVIDER 
4.2 FEDERAL LAWS; APPLICABLE AND REGULATIONS 
1. AMERICANS WITH DISABILITIES ACT (ADA) 
2. OCCUPATIONAL SAFETY AND HEALTH ACT (OSHA) 
3. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) 
4. FAIR LABOR STANDARDS ACT (FLSA)

5. SOCIAL SECURITY ACT (SSA) 

5. STAFFING/PERSONNEL 

5.1. EMPLOYMENT ELIGIBILITY FOR BENEFITS 
5.2. EMPLOYMENT APPLICATIONS 
5.3. ACCESS TO PERSONNEL FILES 
5.4. EMPLOYEE DOCUMENTS ON FILE 
5.5. SALARY ADMINISTRATION 
5.6. EMPLOYEE TRAINING 
5.7. COMPETENCY EVALUATION 
5.8. EMPLOYEE PERFORMANCE RE-EVALUATION 
5.9. STAFFING RATIOS 
5.10. STAFFING SCHEDULE AND AVAILABILITY 
5.11. STAFFING DOCUMENTATION AND RECORDS 
5.2. STAFFING EMERGENCY AND ON-CALL PROCEDURES 

6. EMPLOYEE BENEFIT PROGRAMS 

6.1. EMPLOYEE ELIGIBILITY FOR BENEFITS 
6.2. VACATION PAY 
6.3. RELIGIOUS OBSERVANCE 
6.4. RECOGNIZED HOLIDAYS 
6.5. WORKERS INSURANCE 
6.7. BEREAVEMENT LEAVE 
6.8. RELOCATION BENEFITS 
6.9. EDUCATIONAL ASSISTANCE PROGRAM(S) 
6.10. CERTIFICATION DEVELOPMENT 
6.11. HEALTH INSURANCE 
6.12. LIFE INSURANCE 
6.13. LONG TERM DISABILITY 
6.14. MATERNITY, PARENTAL LEAVE, MARRIAGE, AND DEATH 

7. EMPLOYEE TIMEKEEPING / PAYROLL 

7.1. TIMEKEEPING 
7.2. PAYDAY SCHEDULE 
7.3. TRAVEL REIMBURSEMENT POLICY 
7.4. ADMINISTRATIVE PAY CORRECTIONS 

8. WORK CONDITIONS AND HOURS 

8.1. WORK SCHEDULING 
8.2. OVERTIME COMPENSATION 
8.3. EMPLOYEE ABSENCE POLICY 
8.4. CLIENT NOT HOME TO RECEIVE SERVICE 
8.5. TELECOMMUTING/WORKING REMOTELY (ADMINISTRATIVE) 
8.6. EMERGENCY CLOSURES OF FACILITIES 
8.7. WORKPLACE MONITORING 
8.8. SECURITY INSPECTIONS 

9. WORKPLACE VIOLENCE PREVENTION 

9.1. SEXUAL & OTHER UNLAWFUL HARASSMENT POLICY 
9.2. DRUG & ALCOHOL USE 

10. EMPLOYEE-CLIENT BOUNDARIES 

10.1. WARNING SIGNS OF EMPLOYEE-CLIENT BOUNDARIES BEING CROSSED 

11. WORKPLACE SAFETY 

11.1. OCCUPATIONAL HEALTH AND SAFETY 
11.2. NEW EMPLOYEE JOB SAFETY ORIENTATION 
11.3. SPECIALIZED TASK TRAINING 
11.4. SCOPE OF PRACTICE POLICY 
11.5. CLIENT AND STAFF EDUCATION 
11.6. REPORTING AND DOCUMENTATION 
11.7. PROTECTIVE PERSONAL EQUIPMENT (PPE) 
11.8. CLIENT LIFTING PROTOCOL 

12. EMPLOYEE OUTSIDE WORKPLACE SAFETY 

12.1. TRANSPORTING CLIENTS IN VEHICLE 
12.2. SAFETY RESPONSE (EMPLOYEES) 

13. EMPLOYMENT AT [ENTER COMPANY NAME] 

13.1. JOB POSITIONS IN AGENCY 
13.2. NATURE OF EMPLOYMENT
13.3. EMPLOYER-EMPLOYEE RELATIONS 
13.4. NON-DISCRIMINATION POLICY 
13.5. MANAGEMENT PHILOSOPHY 
13.6. EMPLOYEE IDENTIFICATION 
13.7. WORK UNIFORM 
13.8. COMPANY PRIVACY / CONFIDENTIALITY AMONG EMPLOYEES 
13.9. DIVERSITY 
13.10. BUSINESS ETHICS AND CONDUCT 
13.11. PERSONAL RELATIONSHIPS IN THE WORKPLACE 
13.12. CONFLICTS OF INTEREST 
13.13. OUTSIDE EMPLOYMENT 
13.14. NON-DISCLOSURE OF EMPLOYER INFORMATION 
13.15. INTERNAL JOB POSTING 
13.16. WHISTLEBLOWER POLICY 
13.17. INFORMATION TECHNOLOGY 
13.18. ETHICS AND STANDARDS OF CONDUCT 

14. EMERGENCY PREPAREDNESS PLANNING AND RESPONSE 

14.1. TYPES OF EMERGENCIES 
14.1.1. MISSING CLIENT PROTOCOL: 
14.1.2. CLIENT WANDERING PROTOCOL: 
14.1.3. POWER FAILURE PROCEDURES: 
14.1.4. TORNADO PROTOCOL: 
14.1.5. HURRICANE PROTOCOL: 
14.1.6. FLOODING PROTOCOL: 
14.1.7. BLIZZARD WINTER CONDITIONS PROTOCOL: 
14.1.8. FIRE PREVENTION & SAFETY: 
14.1.9. EARTHQUAKE PROTOCOL: 
14.1.10. MASS SHOOTING PROTOCOL: 
14.1.11. HAZARDOUS MATERIALS AND CHEMICAL SPILL RESPONSE: 
14.1.12. COMMUNICABLE DISEASES AND OUTBREAK RESPONSE: 
14.1.13. VEHICLE ACCIDENT W/CLIENT: 
14.1.14. CLIENT FALLS AND INJURIES: 
14.1.15. GENERAL EMERGENCY INCIDENT RESPONSE 
14.1.16. REPORTING EMERGENCY INCIDENT 

15. REVIEW AND REVISION OF EMERGENCY PLAN 

15. INFECTION PREVENTION AND CONTROL 
15.1. AGING AND INFECTIONS 
15.2. CARE TEAM PROTOCOL 
15.3. HAND HYGIENE 
15.4. DISINFECTION OF SURFACES 
15.5. COMPANY CLEANING PROTOCOLS 
15.6. PERSONAL PROTECTIVE EQUIPMENT [PPE] FOR EMPLOYEES 
15.7. ISOLATE THE SPREAD OF DISEASE 
15.8. RESPIRATORY HYGIENE 
15.9. SOILED LINEN 
15.10. TRANSMISSION PRECAUTIONS 
15.11. OUTBREAK MANAGEMENT 
15.12. INFECTION CONTROL SURVEILLANCE AND REPORTING 
15.13. CONTROLLING COMMUNICABLE DISEASE 
15.14. IMMUNIZATION 

16. EMPLOYEE DISCIPLINE 

16.1. PROBLEM RESOLUTION 

17. EMPLOYMENT TERMINATION 

17.1. PROCEDURAL STEPS FOR EMPLOYMENT TERMINATION: 

18. VOLUNTARY EMPLOYMENT RESIGNATION 

19. HEALTH-INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) 

20. CLIENT RIGHTS AND RESPONSIBILITIES 

21. CLIENT RELATIONS 

22. QUALITY ASSURANCE AND PERFORMANCE IMPROVEMENT POLICY 

23. CLIENT ADMISSION AND DISCHARGE POLICY 

24. REPORTING OBSERVATIONS AND RECORDING DATA 

25. ELDER ABUSE – REPORTING SUSPICIOUS OBSERVATIONS 

26. COMPLAINT AND GRIEVANCE PROCEDURES 

27. CLIENT SATISFACTION REVIEW/FEEDBACK 

28. BUSINESS CONTINUITY 

29. COMPANY RECORDS AND FILE STORAGE (PHYSICAL & DIGITAL) 

30. FINANCIAL BILLING PROCEDURES POLICY 

31. TERMINATION OF SERVICES 

32. CLOSING COMPANY STATEMENT 

33. ACKNOWLEDGEMENT OF RECEIPT