Annual Training Program Documentation

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Created by: Mirabelle Management, LLC (952) 288 - 3800 minnesota Comprehensive home care Licensure Annual Training Documentation Employee Name: __________________________________ Hire/Anniversary Date: _________ Total Required Annually: 8 hours Housing with Services Providers or Arranged home care in HWS Settings 2 hours every 12 months thereafter in topics related to dementia are required Housing with Services Providers Emergency Preparedness Training annually Training Area/Topic Delivery Method Date Competency Completed & Time Allocation Initials 1 EduCare Module: Infection Control Techniques Test Passed Score or % _______ Time: _______ ___________ (Initials) 2 EduCare Module: home care Bill of Rights ___________ (date) Test Passed Score or % _______ Time: _______ ___________ (Initials) 3 EduCare Module: Vulnerable Adult ___________ (date) Test Passed Score or % _______ Time: _______ ___________ (Initials) 4 Organization Policies & Procedures ___________ (date) Test Passed Score or % _______ Time: _______ ___________ (Initials) 5 ___________ (date) Test Passed Score or % _______ Time: _______ ___________ (Initials) 6 ___________ (date) Test Passed Score or % _______ Time: _______ ___________ (Initials) 7 ___________ (date) Test Passed Scor

Created by: Mirabelle Management, LLC (952) 288 - 3800 Minnesota Comprehensive Home Care Licensure Annual Training Documentation Employee Name: _____ Hire/Anniversary Date: _____

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