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ANNUAL EVALUATION - Home Health Consulting

EVALUATIONYear: _____Sample 1-855-PNSystemSample 1-855-PNSystemEMPLOYEE EVALUATION SHEET - PROBATION PERIOD / ANNUAL * (circle)Name of Employee: _____Date of Employment: _____ Position/Title: _____Immediate Supervisor: _____EVALUATIONITEM DiscussedExceptional SatisfactoryNon-SatisfactoryImprovement NeededPersonal appearance/ Code of conduct/ BehaviorPunctuality/Visits Frequency complianceAttitude to work /Attitude to other workers and staff Acknowledgment/ Contract-Agreement reviewedAttitude-Communication with patients/familyResponsibility, JOB DESCRIPTION Discussion in details,follow Physician Plan of Care, Updates as guidelinesInitiative/Duties/Abilities/QA -QI-PI/Agency Evaluationprogram participation/learning experienceMorals/Ethics/Courtesy/Conflic t of interestAbility to record relevant notes, delivery on time,documentation guidelines complianceAbility to communicate in legible, professional manner.

HOME HEALTH AIDE/CNA COMPETENCY TEST (PRACTICAL PART) Competency shall be determined through Observation of the Aide’s Performance of each Activity HHA

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  Health, Annual, Evaluation, Home, Ideas, Home health, Home health aide, Annual evaluation

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