This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.
In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
Care Caregiver Form Application With Database Example In Pima
Category:
State:
Multi-State
County:
Pima
Control #:
US-00458BG
Format:
Word;
Rich Text
Instant download
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FAQ
IF YOU NEED TO FIND OUT YOUR EXISTING HCA NUMBER PLEASE CALL DSS (THE STATE OF CALIFORNIA) AT (877) 424-5778.
To become a caregiver in California, you need to complete a state-approved Home Care Aide training program (40+ hours), pass background checks through the Home Care Services Bureau (HCSB), obtain HCA certification, and complete mandatory safety and infection control training.
Education and examination Long-term care workers must complete 75 hours of training through a program approved by the Department of Social and Health Services, and must successfully pass the home care aide certification examination.
IF YOU NEED TO FIND OUT YOUR EXISTING HCA NUMBER PLEASE CALL DSS (THE STATE OF CALIFORNIA) AT (877) 424-5778.
Verify Caregiver Registration Click here to go to the state's Home Care Aide Registry search page. Enter the caregiver's first name, last name and PER ID#. Click "search". Check the "Status" column to determine if your caregiver has registered and been cleared (passed the DOJ and FBI background check) to provide care.