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Will you have more than one office?

Tell DOH in writing within 30 days of opening or closing an office (WAC 246-335-335(5)).

Do you have a DSHS or area agency on aging (AAA) home care contract?

DSHS does not contract with newly licensed agencies: its home care agency application asks for three years as a licensed Washington agency. Most new agencies start private pay.

Will you provide personal care?

Help with activities of daily living such as bathing, dressing, eating, toileting, personal hygiene, moving around and transfers (WAC 246-335-310(1)). One of the services on DOH's application.

Will you provide housework?

Ordinary housework such as dishes, dusting, vacuuming, laundry, making beds and taking out the garbage (WAC 246-335-310(18)(b)).

Will you provide essential shopping?

Local trips, with the client or for them, for food, medical necessities and household items they need (WAC 246-335-310(18)(c)).

Will you provide travel to medical services?

Driving the client, or going with them by bus or taxi, to a local doctor's office or clinic (WAC 246-335-310(18)(e)).

Will you provide meal preparation?

Planning meals, cooking, setting out food and cleaning up afterwards (WAC 246-335-310(18)(a)).

Will you provide family respite care?

Care that gives a family caregiver a break. One of the services on DOH's application.

Which clients will workers help move between bed, chair, toilet and tub?

Transfers of clients who cannot assist, or who need assistive devices, are home care tasks only after specific training or skills verification under your policies (WAC 246-335-310(1)(j)).

How will workers help clients take their own medications?

This is medication self-administration with assistance (WAC 246-335-310(22); WAC 246-945-714). Workers help only a client who knows they are taking medication, right before they take it (WAC 246-945-718), and never give an injection (WAC 246-945-714(3)).

Will workers help with passive range of motion exercises?

Needs a copy of the client's exercise plan from a physical therapist, occupational therapist or qualified RN, dated within 12 months and saying maintenance only, and a documented skills check for each worker first (WAC 246-335-420(13)).

Will workers help clients take their own vital signs, for information only?

For example handing over a digital thermometer or putting on a blood pressure cuff (WAC 246-335-420(12)(a)). Readings that decide whether or how much medication a client takes need a contracted registered nurse; this manual does not cover that.

Will you provide one-time visits?

For a single visit you may keep shorter written records instead of a full plan of care (WAC 246-335-440(5)).

Will you serve clients under 18?

Records of minors are kept longer (WAC 246-335-450(7)), and suspected abuse or neglect of a child is reported under RCW 26.44.030.

Will workers prepare food for clients on their own?

Workers who prepare food for clients on their own need a food worker card, equivalent FDA food safety training, or home care aide certification (WAC 246-335-430(8)).

Will any caregivers work as self-employed contractors?

Contractors need a written contract, meet the same rules as employees and are evaluated every year (WAC 246-335-425(4), (14)). Check Washington's employment tests with a lawyer before using contractors.

Will you use volunteers or students?

Volunteers and students who have contact with clients need the same background checks, orientation and evaluations as staff (WAC 246-335-425).

How will your caregivers get the 75 hours of required training?

Long-term care workers complete 75 hours of DSHS-approved training within 120 days of hire, 5 of them before giving any care (RCW 74.39A.074), and most must become certified home care aides (chapter 18.88B RCW).

How will you verify a new worker's skills before they work alone?

WAC 246-335-425(9) gives written tests, skills observation and evidence of previous training as examples. The manual includes a skills checklist, and a test with answers if you choose one.

Who answers calls when the office is closed?

The supervisor or a designee must be available during all hours of client care (WAC 246-335-445(4)).

How will the supervisor make the six-month client contact?

The supervisor contacts each client by phone or visit at least every six months to check the plan of care is followed and the client is satisfied, and documents it (WAC 246-335-445(6)).

How will you assess client satisfaction?

Your quality improvement program needs a system to assess client satisfaction with your overall services (WAC 246-335-455(3)).

Which TB test will employees take when DOH's risk form says to test?

Every new employee completes DOH's adult TB risk assessment form, and is tested if the form says so (WAC 246-335-425(12)(c)). Each year employees are reassessed for new risk factors.

How will you keep records?

Client records are legible in permanent ink or retrievable electronically, kept in your office for DOH, and fastened together if on paper (WAC 246-335-450(2)).

Include recommended practices?

Some policies end with practical steps that go beyond the rules, such as worker gift limits and keeping a copy of each training certificate. Once adopted they are your policies and DOH can expect you to follow them, so leave them out if you won't. The DOH review copy always leaves them out.