Final

Personal Care Assistant Service Agreement

1.         The parties to this agreement are: 

_____________________________, who will be referred to in this document as “Client”, who is to receive care and assistance.

Employee, _______________________________, who will be referred to as “Caregiver”. Caregiver’s address and telephone number are:

2.         The purpose of this agreement is to set out the terms of employment and to establish what assistance Caregiver will provide to Client.

3.         Caregiver will assist Client to live at home and to have as much control over the home environment and life as possible, under the circumstances.

5.         Caregiver will be responsible directly to Employer to direct and approve the actions of Caregiver. Services provided may include any of the following:

Personal Services: Assistance with the activities of daily living such as bathing, dressing, feeding, and other activities detailed the Caregiver's Notebook.

Personal Care: Assistance carrying out physicians directions regarding care of Client, carrying out the Care Plan, assistance with mobility and transfers, record keeping, preventing Client from wandering or otherwise harming self.

Household Services: Meal preparation according to a plan approved by Employer, shopping, errands, house cleaning, laundry.

Record Keeping: Caregiver will keep records as set out in Caregiver’s Notebook.

Caregiver will accompany Client on errands and appointments as directed by Employer.

Caregiver will know the whereabouts and the physical condition of Client at all times while on duty, and will keep Employer informed of any changes.

Caregiver will make a written record of any accidents or other sudden events that bring harm or risk of harm to Client. Caregiver will make use of emergency contact procedures to speak with a Employer representative personally about any such incidents.

7.         Work Schedule. Caregiver agrees to work according to a schedule established by Employer...