Employee Resources

Agency Manager: Kyle Martinez

Client Care Coordinator: Lily Koile

Agency Manager: Brenton Martinez

Client Care Coordinator: Shelley Stevens

Agency Manager: Tyler Martinez

Client Care Coordinator: Brynli Dowd

• PCPs will work together as a team to provide Personal Care and Homemaking services to all clients in the area they serve.

• PCPs will work as scheduled. However, it may be necessary for TOC to change an employee's schedule during the week to meet changing client needs.
• Office staff will direct and re-direct PCPs as necessary. PCPs will report client concerns to office staff as they arise. The Client Care Coordinator will be a primary contact for PCPs.

• PCP Supervisors will act as counselors and as disciplinarians when necessary. Supervisors are always available to discuss employment questions or concerns.

• Management staff are available to address any issues not promptly or properly handled by other administrative staff.

• PCPs will be supervised regularly in clients’ homes or through Telehealth.

• All clients have Supervised Visits once per calendar quarter.

• During a Supervised Visit:

• PCP should continue to work, performing needed tasks.

• Administrative Staff member will speak to client, observe PCP’s work performance, and discuss any concerns.

• PCP Evaluations

• PCPs are evaluated after the first three months of work, after one year of work and annually thereafter.

• Evaluations are performed by the PCP Supervisor, with input from all office staff who work with PCP.

• PCP Supervisors also review the PCP’s chart, including any counseling, Supervised Visits, Employee Notes regarding performance or attendance, and any other documentation, before completing the Evaluation.
• If a PCP has a question about their Evaluation, he/she should contact the PCP Supervisor to discuss it.

If an employee comes into the office to discuss a client issue or concern, that employee should ask to speak to administrative staff privately.

If employees see co-workers anywhere other than the office (Wal-Mart, church, City Market, etc.) the employees should NOT discuss clients.

Employees may not share PHI about their clients with anyone, even if that person knows the client.

It is often necessary to discuss client conditions with other professionals such as hospice or home health workers. If a conversation regarding a client’s PHI is

necessary to provide appropriate care, this is allowed.

In an emergency, employees may release PHI to emergency personnel (police dept., fire dept., 911 Operator, etc.).

Emergency Contact Information and Procedures

If a client experiences a health emergency; employees shall follow this procedure:

1. Assess the situation. Does the client need emergency help? If you are unsure, call the office for guidance. If you are sure, proceed to step 2.
2. Call for help. For most clients, you will call 911. For Hospice clients, you call the appropriate Hospice. If a client has a Lifeline, you can push the Lifeline.

Touch of Care has a 24 hour on-call service available for client and PCP use.

To reach an on-call staff member in an emergency, or with an urgent question, dial the regular TOC phone number and leave a message with the following information:

1. Your Name

3. Return Phone #

Other numbers: In the event of a natural or man-made disaster, the on-call number may malfunction. In that case, you can use these numbers:

Kyle Martinez (970) 773-1989

Brenton Martinez (970) 201-9020

1. Provide Information. Whoever you call for help, they will ask you questions about the client and the situation. Stay calm and provide answers. If the client has a DNR, be sure to make that known to the emergency personnel. This information is located on the client’s Plan of Care.

1. Keep the client calm and comfortable. Stay with the client wherever he/she is. Provide reassuring comfort that help is on the way. Do not perform skilled procedures; wait for help to arrive.
2. Notify Touch of Care. Once the client is safe, call the office to give a report about what happened.

Clients will continue to receive care as scheduled, if possible, in the event of an

Emergency.

All PCPs should continue to work as scheduled, if possible.

• If a PCP cannot get to work or feels it is unsafe to go to work, he/she should attempt to contact Touch of Care’s office or on-call person.
• Administrative staff will work to contact each PCP to determine if they can or cannot work as scheduled. If limited staff is available to work, Touch of Care will triage clients. Touch of Care will attempt to contact client(s) or their authorized representatives to inform them of any changes in the scheduled care.
• If phone service is out for an extended period of time, Touch of Care will utilize radio or television to communicate with employees.
• If it is impossible to distribute new schedules, employees should repeat their current week's schedule, unless otherwise directed by Touch of Care.

Elder Abuse and

Reporting Process

• Non-accidental use of force that results in physical pain, injury or impairment in an elderly person.

• When people speak to or treat elderly people in a way that causes emotional pain or distress.
• Intimidation, humiliation, ridicule, ignoring, or isolating.

• Sexual contact with an elderly person without the elder’s consent.

• Physical sex acts, showing pornography, or forced undressing.

• Failure to fulfill a caretaking obligation; leaving an elderly person at a hospital or other public place.

• Failing to provide for the elder’s needs.

• When the elder chooses not to provide for his/her own needs, either willingly or because of physical/mental impairment.

• Lack of hygiene, unsanitary home, or lack or medical care.

• Unauthorized use of an elderly person’s funds or property.

• Misuse of money or household goods, forgery or identity theft

Victim is a Touch of Care client

You suspect

TOC calls Case Manager/Family

Case Closed, or APS

works to help client.

Client declines

or accepts help.

TOC calls APS

CM/APS ask client

if helped is desired.

APS= Adult Protective Services

Offer Protection for any “At-Risk Adult”

• Susceptible to mistreatment or self-neglect because he/she is unable to perform or obtain services necessary for their health, safety, and welfare

• Lacks sufficient understanding or capacity to make or communicate responsible decisions.

1. Provide information and referral to referring party or agency when the allegation does not involve the mistreatment of an at-risk adult.
2. Contact the responsible care provider who is not the suspected perpetrator to resolve the issue.
3. Conduct an investigation of all the allegations and adult’s overall well-being and provide protective services including law enforcement referral for alleged crimes as appropriate.

• Requires the least restrictive intervention.

• Focused on the at-risk adult

• Case Plan includes only services the adult agrees to.
• Adult cannot be removed with-out consent.

• Does not investigate emotional

• Often very restrictive

• Focused on the whole family

• Child can be removed in an emergency situation without consent.

• All cases are court ordered

• Investigates emotional abuse

Colorado Mandatory Reporting Laws state:

• You MUST report the abuse to police or local law enforcement within 24 hours after making the observation or discovery of abuse.

• Failure to report OR filing a FALSE report can be prosecuted under the new law. If you are a mandatory reporter and you willfully fail to make a report of observed or suspected abuse, neglect, or exploitation of an at-risk elder, it is a class 3 Misdemeanor.

Know the Signs & Symptoms of Abuse

Make Reports to TOC promptly when you have suspicions.

Understand the Role of APS and its limitations

Follow mandatory reporting laws

• Makes the client feel special.

• Is a little thing that makes a big difference.

• Shows that we care.

• Makes TOC an agency of excellence.

• Homemaking tasks for each client will be assigned on the client’s Plan of Care.

• It is your responsibility to read the Plan of Care for each client you see.

• Read each Plan of Care carefully and re-read it often.

• Follow the Plan of Care

• If a task is needed and is not on the POC, call the office for approval before you perform it.

• Touch of Care’s goal is to always provide the highest quality of care.

• We perform light housekeeping, but this does not mean we cannot keep our clients’ homes very clean.
• Always leave a client’s home better than you found it.

• If a client is reluctant to accept needed tasks, let the office know.

• Talk to your client about his/her priorities for the visit and do those things first. If the visit is a Personal Care Visit-Personal Care must be prioritized first.

If time is limited, take into account the greatest needs in the home. Kitchens and bathrooms should always be a priority for a homemaking client. If you do not have time for all the tasks on the Plan of Care; let your Client Care Coordinator know.

Extra Cleaning (as time allows)

• Clean cobwebs from corners with a broom.

• Vacuum/mop corners well in all rooms.

• Clean windowsills, inside windows and blinds.

• Wipe down spots on walls as you see them.

• Sanitize doorknobs, lights switch, and phones.

These cleaning tasks are great to do when you have 15 minutes left at the end of a visit and are not sure what else to do.

• Can use to clean just about anything, a small amount mops floors well.

• Cleans bathtub rings

• After washing dishes, fill sink with hot water and some dish soap to clean counters and kitchen appliances.

• Disinfectant of choice for AIDS/Hep B clients.

• NEVER mix cleaning products

• Always read labels before use

• Smells good but makes floors sticky MSDA sheets are available in the office.

When your time is limited, here are the tasks you should focus your energy on:

(Personal Care-if on the Plan of Care-always a priority)

Meals: Make sure the kitchen is clean, and the client has fresh, nutritious meals

and snacks for the day and until his/her next scheduled visit.

Clean Bathroom: Make sure the toilet, commode, or urinal and the sink are clean.

Clean, Fresh Bed: Make sure the client’s linens are neat, clean and inviting for rest.

The Rest: Once these priority tasks are done, work on the other tasks on the Plan of

Care.

Handling Hantavirus Pulmonary Syndrome (mice feces)

If you come in contact with mice feces, contact the office immediately and they will give you directions on how to proceed.

How to Succeed at Keeping Client’s Homes Neat and Clean

TOC Standard: Sweep all hardwood, linoleum, and tile floors at least once per week, before mopping.

• TIPS:

• Pick up rugs and mats. Shake them off and sweep underneath them.

• Move kitchen chairs and other light objects; and sweep underneath them. • Use broom to remove any cobwebs.
• Sweep all dirt into dustpan, dump dustpan into trash can.

TOC Standard: After you sweep, mop all hard wood, linoleum, and tile floors at least once per week.

• TIPS:

• Ask client what cleaner is preferred.

• Pour a small amount of cleaner in bucket, then fill bucket with hot water.

• Read and follow the instructions on cleaner’s package.

• Dip Mop in bucket, wring out water well, wash floors in an “S” motion.

• Always mop yourself out of a room.

For Your Safety:

• NEVER walk on a wet floor.

• Notify TOC of unsafe mopping conditions like very heavy or old mops.

For Client Safety:

• Always dry the bathroom floor after the client bathes.

• Always assure that the client does not walk on a wet floor.

TOC Standard: Dust each room in a client’s home at least once per week. Dust top to bottom.

• TIPS:

• Always use the appropriate cleaner. (follow directions listed on package)

• Wood surfaces: Use cleaner such as Pledge to protect wood.

• Other surfaces: Use 409 or a glass cleaner for glass and other surfaces.
• Mirrors: Use paper towels instead of rags to eliminate streaking.

• TIPS Continued:

• Always pick up objects; dust the objects as well as underneath them.

• Always put things back where they were. Pay attention to each knick-knacks place before you move it.

• Don’t forget windowsills and picture frames.

• You can clean inside the windows, but not outside of them.

TOC Standard: Vacuum thoroughly at least once per week.

• TIPS:

• If no attachments are present, use a small broom in small corners and edges.

• Be courteous about the noise the vacuum creates. Do not vacuum while clients are asleep, on the phone or have guests visiting.

• Ask, “Do you mind if I vacuum now?”

• While vacuuming, clean all areas possible without moving heavy furniture.

• Vacuum slowly to avoid bumping baseboards and furniture.

• Move the vacuum forward and back over each area of carpet; if very dirty, vacuum in a + shape.
• Change the Vacuum bag/empty canister as needed.

TOC Standard: Empty all trash in a client’s home daily, especially if it contains soiled briefs or blue pads.

• TIPS:

• Save plastic grocery bags to line small trash cans.

• “Double-Bag” infectious waste.

• Clean trash cans when dirty inside or out.

TOC Standard: Make the bed daily; change linens one time per week or more as needed.

• TIPS:

• The first time you go, look at how the bed is made. Each client’s preferences are different.
• After you have made the bed, it should look just like it did when the sheets were fresh.
• Tuck top sheets and blankets under the bottom of the mattress to hold them.

Add a Touch of Care:

• Smooth out wrinkles, which can cause bedsores.

• If the client is incontinent, place blue pads on the bed to protect it.

TOC Standard: Clean the bathroom

• TIPS:

• Clean sink using a cloth or sponge and cleaner the client has on hand, preferably a disinfectant. (Replace sponges often.)

• Read and follow the directions on the cleaner’s package.

• Clean all surfaces, including the counter, and rinse well. Pick up items on counter. Clean them and clean under them. As well as the mirror/medicine cabinet.

• TIPS:

• Clean bathtub/shower using a cloth or sponge and cleaner the client has on hand, preferably a disinfectant.

• Read and follow all directions on the cleaner’s package.

• Clean all surfaces, and rinse well.

• If you see mildew or mold, call the office for direction.

• Clean toilet well:

• Squirt toilet bowl cleaner under the rim of the toilet bowl. Allow it to set while you…

• Spray a disinfectant cleaner on ALL toilet surfaces, including the floor nearby. Wipe clean with a wet rag. This includes the lid, seat, outside of bowl. Flush when done. (Do not clean other surfaces with this rag)
• Add a Touch of Care: For stains; use a pumice stone to scrub clean. If there is a toilet riser, clean it and underneath it.

For Your Safety: ALWAYS wear goggles while cleaning the bathroom.

Do this even if there are just a few dishes or if there is no dishwasher.

• Clean sink before you begin. Squirt a little dish soap into the sink. Use a clean wet cloth to cleanse sink and surrounding area. Rinse with hot water. Plug the clean, empty sink with a stopper. Then run hot water into the sink; while it’s running, add a squirt of dish soap.

• Use a clean cloth to clean all dishes. Proceed to wash glasses first, silverware, plates/bowls, then pots and pans. Rinse dishes well with hot water; dry with a clean towel or air dry (per client preference), put away.

• Be SURE dishes are very clean with no remaining food or residue.

Dishwasher Use:

• Rinse dishes well with hot water and a cloth or brush before loading them into the dishwasher.

• Put plastic items on the top shelf to prevent melting.

• Straws, medicine cups, specialty items should not be washed in the dishwasher.
• Put dishwasher soap in, adjust settings, and run. Put dishes away following the end of the cycle.

For Your Safety: Do NOT put sharp objects like knives in a sink full of water. Wash them separately and carefully. Close cabinet doors and drawers immediately.

TOC Standard: All surfaces including counters should be wiped down with warm water and dish soap.

• Clean cabinet doors, knobs, and small appliances (microwave, toaster, etc.)

• Inside of fridge and oven should be cleaned monthly or per client request.

• Clean out old food.

• Clean oven using water and vinegar.

TOC Standard: Pick up/ tidy client’s living area daily.

• Make the living area inviting by keeping it clean and placing items a client needs or enjoys near his/her chairs.

• Glass of water

• Books or magazines

• TIPS:

• Sort clothes by color. Light colors and whites together; dark colors and blacks together.

• Wash dark colors in cold water, wash towels and undergarments in warm or hot water. Be sure to treat spots as needed.
• Read labels on clothing for specific instructions; watch out for delicates.

• NEVER cram too much laundry into the washer.

• Do not let laundry sit in the washer; it will mildew.

• Note that some clothes need to air-dry. Follow instructions on label.

• Dry clothes on fabric-appropriate heat setting, see directions on machine.

• Remove clothes from dryer promptly, fold, hang and put away.

• Do not leave clothes wet; do not leave clothes for client to put away.

• If you cannot finish laundry at your visit, contact the office for direction.

Try to prepare healthy meals, incorporating foods from each food group.

• Protein: Meat, eggs, poultry, and fish

• Milk: Cheese, yogurt, and pudding

• Starch: Bread, pasta, and rice.

• Vegetables

• Fruits

• Check client’s Plan of Care for any dietary restrictions.

• If a client refuses to eat while you are there, prepare a sandwich or snack for later.

• Buy cold food last and get it home fast.

• When running errands, get groceries last.

• Never leave food in a hot car.

• Don’t buy food client can’t use by the Use by Date.

• Proper food storage temperatures

• Refrigerator= 40-degree F; Freezer= 0 degrees F. General rule is to keep fridge as cold as possible without freezing milk or lettuce. The freezer should keep all food frozen solid.

• Safe storage of meats

• Freeze fresh meat immediately if it won’t be used within a few days.

• Freeze in appropriate servings, i.e. divide 1lb of hamburger into 3 portions.

• Store packages of raw meat on a plate so they don’t drip into the refrigerator shelves.
• Thaw frozen food in the refrigerator or microwave, not on the counter.

• Follow defrosting instructions on microwave if used to thaw meat.

• Keep food preparation areas and tools clean. This means washing your hands before preparing food.

• Bacteria can live in kitchen towels, sponges, and cloths. Wash cloths after two days of use, or more often as necessary. Replace sponges often.

• Keep raw meat and their juices away from other food. Wash all utensils used to handle raw meat in hot, soapy water. Do this before dicing other ingredients.
• Cook food thoroughly. Red meat: brown or gray inside. Poultry: until juices run clear. Cook fish until it flakes with a fork. Cook eggs until yolk & white are firm.

• Microwave Safely. Microwaves can leave cold spots in foods where bacteria can survive.
• Cover food with a lid or plastic wrap so steam can aid in thorough cooking.

• Stir and rotate food for even cooking. Observe “standing” time in recipes.

• Proper Food Storage

• Never leave food out for more than two hours.

• Serve food on clean dishes.

• When cooking ahead, separate into small portions and date all leftovers.

• Keep it too long? When it doubt, throw it out.

• Anything containing cooked meat is good for three days. Cooked vegetables are good for five days.
• Follow expiration dates closely. If anything looks or smells strange, discard.

• Lunch meats are good for one week after opening.

• Wash fruits and vegetables before using.

• Constantly keep counters and food preparation surfaces clean.

• Turn your face away when coughing or sneezing, then wash hands.

Encourage clients to drink plenty of fluids.

Offer water at each visit.

Set a glass of water by the client’s chair.

• Shop for clients at a local store.

• If possible, limit shopping to once or twice per week.

• Work with the client to make a weekly menu and grocery list.

• Keep the list handy so the client can add things when needed.

• Never pick up fast food or food from any restaurants.

• Many clients are particular about their groceries.

• Make sure you understand what the client wants. If the item is unavailable, call the client (*67 before phone #, this will block your number) from the store, and ask if you should purchase something else.

• When you get back…

• Return any change and receipt to the client then proceed to put all groceries away promptly.
• Use a Cash Transaction Record when cash, a check or a card is used. This includes money spent at the laundromat. List amount or if no funds were necessary.

Safety Information and Universal

Precautions

• Touch of Care has a very strong focus on Safety.

• YOU, the Personal Care Provider, are essential on our team. If you are not safe, you will not be able to care for our clients.

• Complete a Safety Concern Report if necessary.

OSHA=Occupational Safety and Health Administration

• Designed to keep employees safe at workplaces across the country.

• Touch of Care complies with all applicable OSHA standards.

Hazard Communication

• Employees have both a need and right to know the hazards and identities of the chemicals they are exposed to when working, and to be supplied with appropriate PPE.
• Employees will only use the Consumer cleaning products. However, MSDA will be available to all employees on all common products at each TOC office.

Bloodborne Pathogens

• Bloodborne Pathogens are infectious materials in blood that can cause disease in humans, such as Hepatitis or HIV.

• TOC will protect employees through ongoing training, PPE use, reporting of exposures and post-exposure treatment.

Exit Routes

• Employees will be informed on the Safety Assessment form which are the safest entry and exit points from each client’s home.

Emergency Action Plan

• TOC has an Emergency Situation Procedure to handle Client Emergencies.

• We also have an Emergency Preparedness Plan.

Fire Safety

• TOC Employees will not attempt to extinguish any fire other than a kitchen fire, according to the Home and Fire Safety Training.

• If any other fire starts, employees should evacuate themselves and the client from the home immediately and call for help.

Medical Treatment and First Aid

• TOC will provide gloves to prevent employee’s exposure to blood and/or bodily fluids. All employees will be provided with a basic First Aid kit and training.

• Employees must report all incidents when First Aid is used.

Personal Protective Equipment (PPE)

• TOC will provide all necessary PPE to employees to prevent exposure to blood or bodily fluids. This includes gloves, goggles, masks and gowns.
• Employees will be trained on proper use of PPE on an ongoing basis.

Ergonomic Hazards

• TOC will train employees on proper body mechanics & safe lifting techniques to prevent injury.
• Employees do not lift clients who cannot assist. Do not perform heavy lifting at any time.

Slips, Trips and Falls

• TOC will provide ongoing training on walking safely on all working surfaces, and Safety Assessments note hazards.
• Use ice kits as necessary during Winter months to prevent falls.

• TOC requires NO walking on wet floors and prompt cleanup of all spills.

OSHA

Standards SAFETY

• Report all accidents or near misses to your supervisor before the end of your shift. (Falsifications of any company records will not be tolerated.)

Hazard Reporting

• Employees are responsible for notifying a supervisor immediately of any unsafe condition/or practice. This includes reporting condition changes not on the plan of care.

Adherence to Safety Assessment Recommendations

• Employees are responsible for reading the Safety Assessment for each client & adhering to all recommendations made on the assessment.

Alcohol & Illegal Drugs (this includes Marijuana)

•

No illegal drugs or alcohol will be allowed on the work site.

Employees will notify their supervisor of any prescription drugs that might affect their judgment.

All employees who drive or ride in a vehicle on company business must wear seatbelts and obey all traffic laws.

Report any traffic tickets to your supervisor within 3 business days.

Horseplay

• Wrestling, running, pushing, throwing any items in play or other disorderly conduct is forbidden.

Hazardous Materials

• Follow proper use and handling procedures for hazardous materials.

• Do Not use a chemical if you are not familiar with the hazardous properties or have not been trained on the required protective equipment.

• Employees must adhere to TOC’s oxygen policy for safety around Oxygen.

Housekeeping

• All employees are required to keep their work area clear of debris or other tripping or slipping hazards. All debris must be disposed of properly.
• Never reach into a trash can and never walk on a wet floor. Never step into a wet bathtub for any reason.

Universal Precautions

• Employees must practice proper use, care and storage of personal protective equipment and must follow hand washing procedures.

Signs/Labels

• Pay attention to all signs and labels. They are reminders for safety.

Drinking Water

•

Always drink from regular water fountains or water coolers as water from any other source may be unsafe to drink.

It is each employee’s responsibility to maintain personal hygiene, and

always wash your hands before/after eating/smoking.

Winter Safety

• Wear proper footwear during Winter months.

• Keep Ice Kits with you at all times.

• During Winter months, be sure to take your time, and pay attention to weather before leaving for a client’s home to ensure you give yourself enough travel time.

Prohibited Tasks

• Employees should never move furniture or heavy objects; this also includes staying off ladders or doing any work outside of a client’s home.

Pet Safety

• It is each employee’s responsibility to act responsibly around client’s pets.

• Employees shall not play with, pet or walk client’s pets at any time. Pets should be restrained at all times.
• If an employee feels unsafe near a client’s pet, employee shall contact the office for direction.

Concentrate

• Most accidents can be avoided by concentrating on the job at hand. Always be aware of your surroundings and what is going on around you.
• Safety is a full-time job.

Counseling & Accident Investigations

• Safety is a top priority at Touch of Care.

• All safety violations will result in employee counseling and all accidents will be investigated to prevent similar future occurrences.

General Care of Your Body

• You only have one body! Use it right to keep it healthy.

• Stretch regularly, before and during work.

• Take rest breaks.

• Alternate heavy tasks with light tasks. (vacuuming; dishes)

• Alternate muscle groups

• Switch hands/arms whenever possible.

• Change arms when vacuuming when you move from room to room.

• Alternate the hand you use at the top of the mop or broom.

Green: Tasks you can perform with elbows close to your body.

• Green is the good zone. This is the zone you should be in most of the time.

• Tasks you perform often should be done in this posture.

Yellow: Tasks you can perform with arms outstretched, with your torso aligned.

• Yellow is the sometime zone. If you find yourself performing many tasks in this posture, move your body closer to your work.

Red: This is the BAD zone. Stop and reassess your safety.

• If your torso is out of alignment, it causes strain on your back. Reassess your task or call the office for help.

Lift slowly and in a controlled manner.

Inspect your path of travel before the lift and remove any hazards.

Focus on keeping the load close to your body. Keep fingers away from edges to avoid pinches.

Test the load prior to the lift. Do not lift anything that is too

heavy. Call the office.

Step out of the way if any object falls. If a client falls, guide them to the floor.

Avoid twisting, bending or reaching during a lift.

Feet should be shoulder width apart or wider.

Eliminate lifting heavy things above shoulder height.

Let your legs do the lifting; don’t use your back.

You are the key. Always follow proper lifting guidelines.

Infection Control attempts to prevent the spread of germs from one person to another.

You will need to practice Infection Control practices and Universal Precautions when caring for clients.

Good Personal Hygiene Practices promote health and are an important part of

Infection Control.

As an employee at Touch of Care, you should follow these practices:

• Wash your hands according to TOC protocol (to follow in this section)

• Keep your hands and any unclean articles away from your mouth, eyes, ears, genitalia, and wounds. Wounds should be cleaned and covered.

• Always cover your mouth when you sneeze or cough to shield others from your germs.
• Do Not come to work if you have a fever or infectious disease such as the flu, or other illness.
• See Employee Health in your Personnel Manual.

• Keep your body clean by taking daily baths or showers and by brushing your teeth at least twice each day.

• Handwashing is the single most important measure for preventing infections.

• TOC protocol is to wash your hands according to the following procedures:

1. Take 15-20 seconds to wash your hands using soap and running water.

1. Rub all surfaces of your hands vigorously, making sure to wash between fingers and under nails.
2. Rinse hands and dry them. If possible, use a clean towel to turn off the faucet to avoid re-contaminating your hands.

TOC Protocol also requires that you wash your hands at the following times:

• Before and after you:

• Touch a client/perform any hands-on personal care, even if you were wearing gloves.

• Before you:

• Come on duty, prepare meals, or eat.

• After you:

• Remove gloves, soil your hands, come in contact with blood, etc.

• Personal Protective Equipment includes gloves, goggles and masks. It is designed to prevent employee exposure to blood, bodily fluids, or other potentially infectious materials.
• Touch of Care will provide Personal Protective Equipment at no cost to you.

• You will be responsible for maintaining an adequate supply of gloves and masks for your use.

You can pick up gloves, masks, and goggles at the Touch of Care office.

Universal Precautions is the practice of assuming that all blood, body fluids, and any other possibly infectious materials are contaminated with HIV virus.

This is not the case, but treating all of these substances as contaminated will protect you in the best possible way.

• Wear gloves any time there is a POSSIBILITY that you MIGHT come in contact with blood or any other bodily fluids.

• Examples:

• Bathing

• Skin Care etc.

• Change gloves whenever you:

• Change tasks. When you finish a task like meal prep, change your gloves before you start washing dishes.
• Come in contact with blood or bodily fluids. After you clean the toilet, remove your gloves and wash your hands. Don clean gloves before new task.

• See a rip or tear in the glove.

For Your Safety: Do NOT re-use gloves!

• Choose gloves that fit you well.

• Procedure:

• Wash hands, don gloves

• Perform task.

• Remove gloves, wash hands.

• Removing gloves

• Grab first glove from inside of wrist and turn inside out as you pull off. Grasp that glove in the still-gloved second hand. Grasp from inside of wrist and turn inside out as you pull off. Discard both gloves.

• Wear a mask to prevent the spread of germs & to protect yourself from allergies.

• Examples:

• You are performing hands on mouth care.

• You are dumping a bedside commode or emptying a urinal into the toilet.

• You or your client has an infectious illness.

• You or your client is coughing or sneezing.

• Remove mask after removing gloves and washing hands.

• Discard used masks; do NOT re-use.

• Wear goggles to prevent the spread of germs & to protect your eyes from any materials that could come in contact and damage your eyes.

• Examples:

• Emptying a urinal

• If a splash occurs, remove goggles and clean prior to next use.

• Infectious waste is any blood, bodily fluid, or possibly infectious material.

• Examples: Used depends or bed liners, any other article contaminated with feces, urine, or blood. (Place soiled clothes or linens in a plastic bag until they can be washed.)
• Bagging: Place infectious waste in a bag: tie the bag closed and place that bag in a client’s garbage.
• Dispose of garbage promptly in outdoor receptacle.

Personal Care

Remember to follow Infection Control and Universal Precautions

• Follow TOC Protocol for Handwashing

• Wear gloves and masks

• Wear gloves when performing any hands-on personal care or when there is a possibility that you might come in contact with blood or bodily fluids.

• Double-bag Infectious Waste

Allowable Tasks Non-Allowable Tasks

• Assistance with Activities of Daily • Living (ADLs) including: ambulation,

bathing, dressing, medication • reminding, nail care, etc.

• Homemaking Services including: • Bedmaking, dishwashing, laundry, etc.

Any nursing or physical therapy procedures; any skilled Personal Care

Services provided to anyone other than the eligible client (Medicaid)

Miscellaneous: financial management, ironing, applying of fingernail polish,

pet care, etc.

HOA = Hands on Assist

SBA = Standby Assist

Treat each client with dignity and respect.

Never perform Skilled Personal Care.

Encourage self-care.

Report and document any concerns.

Perform each task with a Touch of Care.

Provide as much privacy as possible.

• Always observe the client while performing personal care.

• Any strange or startling behavior should be reported by phone to the office promptly and documented on the client’s visit note.

• Always report and document significant events.

Significant events must be reported to the office as soon as you learn of them.

Types of things to report:

• Falls or increased weakness

• Personal Care tasks for each client will be assigned on the client’s Plan of Care.

The Plan of Care is on your Axis Care app.

• Read each Plan of Care carefully.

• Follow the Plan of Care.

• If a Needed task is not on the Plan of Care, call the office for approval before performing it.

• Ambulation is: Assisting a client to walk.

• Client must be able to balance and bear weight.

• Client may ambulate with a device such as a cane or walker.

• HOA: Hands on assistance to prevent falls.

• SBA: Watching client closely, being nearby.

• Safe Procedures

• Wash hands before client contact.

• Discuss procedure with client.

• Have client dangle legs off bedside before standing up (if client is in bed)

• Safe Procedures Continued

• Have client scoot forward with buttocks at the edge of the bed or chair.

• Assure client of safety: proper shoes, clear pathways, etc.

• Assist client to stand (Transfer)

• You can do this any way that is most comfortable for you and the client.

• See Transfers Section for sample techniques.

• Walk with the client, providing support as needed:

• Arm to arm

• Behind client, hands on waist or gait belt.

• Observe client for exhaustion. If short of breath, have client stop and rest.

• Help client back to a safe, comfortable position.

• Report any abnormalities to the office.

Bathing is: Assisting a client with any aspect of bathing.

• HOA: Helping a client to wash the body in bed or in the bath/shower

• SBA: Assisting a client to prepare for bathing; to get in/out of the bath/ shower; to be nearby (in line of sight) in case client falls.
• Use bathing as an opportunity to check skin for red areas, which may be signs of skin breakdown, report to office.
• Make sure the room you are bathing the client in is nice and warm.

• Gather all bathing supplies, towels, soap, etc.

• After bathing, always offer skin care, dressing, and hair care.

Bed Bathing is: Helping a client bathe in bed when he/she cannot get into the tub/shower.

• Safe Procedures:

• Wash hands before client

contact; don gloves.

• Provide privacy and maintain the client’s dignity: assist client

to remove clothing, and cover

• Discuss procedure with client.

• Assemble all equipment needed (soap, towel, etc.)

• Encourage self-care as possible.

• Fill basin with clean water.

client with sheet or blanket. Only expose the area being washed.

• Protect the client’s bedding by lining bed with plastic material

or extra towels.

• Safe Procedures Continued:

• Always wash, rinse, then dry each area before moving on to the next, to prevent chilling. Be very gentle with client’s delicate skin.

• Bathe the client in the following manner:

• Place towel on chest area and wash client’s face.

• Place a towel under one arm; wash; repeat on opposite side.

• Place hands in basin and wash.

• Wash chest and stomach.

• Place towels under legs as the front sides are washed.

• Safe Procedures Continued:

• Place feet in basin and wash.

• Change water.

• Turn client to side facing away from PCP and wash back sides of legs, back and buttocks.

• Clean perineal (private) area, or allow client to do so, if able.

• Apply lotion/powder to skin as needed or requested.

• Assure the client’s bedding is dry and comfortable.

• Safe Procedures Continued:

• Assist client with dressing and help client into a safe, comfortable position.

• Remove gloves, wash hands.

• Clean up all bathing supplies.

• Report any abnormalities to the office.

• Sponge Bath:

• This is using Bed Bath techniques outside the bed to help client clean up certain areas of the body without getting wet all over.
• This is common for the face, hands, and underarms.

• How much help does the client need? Just ask.

• Most clients primarily need assistance getting in and out of the shower; cleaning their back or feet; and washing hair.
• Alzheimer’s clients can often bathe themselves if you cue them.

• Safe Procedures:

• Wash hands before client contact, don gloves.

• Discuss procedure with client.

• Assist client to walk to bathroom. (Ambulation)

• Safe Procedures Continued:

• Provide privacy for client; maintain client’s dignity.

• Assist client as needed to remove clothing.

• Encourage as much self-care as possible.

• Run water at a safe temperature

• Start with cold, and add hot, until warm temperature is established.

• When turning off water, turn off hot first, then cold to prevent scalding.

• Assist client in getting safely into the tub or shower.

• Most clients use a bath bench in the shower.

• If a client does not have a bench and needs one, call the office.

• Assist with bathing, hair care (washing) as needed.

• Assist client in getting safely out of the tub or shower.

• You can place a towel on the toilet for client to sit on. Wrap client in a towel and walk with client to sit on toilet.
• Dry skin surfaces gently and thoroughly; prevent chilling.

• Safe Procedures Continued:

• Apply lotion/powder to skin as needed or requested.

• Assist client with dressing and help client into a safe, comfortable position.

• Remove gloves, wash hands.

• Clean up bathing area. Be sure the tub/shower is clean, towels and dirty clothes are picked up, and the floor is dry.

• Report any abnormalities to the office.

Bladder Care is: Assisting client with any aspect of urination.

• Examples:

• Helping a client ambulate (walk) to the bathroom

• Helping a client get cleaned up after bladder incontinence (accidents)

• Helping client clean perineal (private) area after elimination

• Cleaning bedside commode

• Emptying a catheter bag

• Safe Procedures for Toileting:

• Wash hands before client contact, don gloves

• Discuss procedure with client.

• Assist client to walk to bathroom/bedside commode (ambulation)

• Assist client to pull clothes down if necessary

• Provide privacy for client

• Safe Procedures Continued:

• After the client eliminates, assist with wiping is necessary

• Wipe from front to back to prevent infections

• Many clients use wet wipes-dispose of properly.

• Assist with changing pads, Depends, or clothes if necessary.

• Remove gloves, wash hands.

Safe Procedures for Catheters:

• Empty catheter bags before they are full.

• Don gloves and goggles.

• Discuss procedure with client.

• Empty catheter:

• Open the drain spout and release urine into the urinal or other container designated for that purpose. Close drain spout, and carefully dump urine into toilet then sanitize container.

• Remove gloves, wash hands.

• Safe Procedures for Urinals (for male clients):

• Don gloves and goggles.

• Discuss procedure with client.

• Bring clean urinal to client.

• Provide privacy for client with a blanket, towel, etc.

• Help client with unfastening clothes, if necessary.

• After client eliminates, carefully dump urine into toilet. Then sanitize urinal.

• Help client re-fasten clothes, if necessary.

• Remove gloves, wash hands.

• Safe Procedures for Cleanup:

• Don gloves and goggles before beginning cleanup.

• Clean bedside commode after each use.

• Add water to canister, carefully dump waste into toilet, repeat as needed and then sanitize commode with a disinfectant.
• Clean urinals and catheter cups after each use.

• Carefully dump waste into toilet and sanitize with a disinfectant.

• Clean toilets if they are visibly dirty, according to homemaking procedures.

• Double bag any soiled Depends or blue pads and throw away in an outdoor receptacle.
• Remove gloves, wash hands.

Bowel Care is: Assisting a client with any aspect of bowel elimination.

• Examples:

• Helping client to pull clothing up or down.

• Changing a client’s Depends after a bowel accident.

• Helping client-directed ostomy care when there is no skilled skin care and no reporting required.

• Assisting a client to clean perineal (private) area after elimination.

• Safe Procedures: Follow safe procedures for toileting from Bladder Care.

• Safe Procedures for Ostomy Care:

• Wash hands before client contact, don gloves and goggles.

• Discuss procedure with client. Client MUST give you directions.

• Clean ostomy equipment, carefully dumping waste into toilet, then sanitizing.
• When clean, give equipment back to client.

• Remove gloves, wash hands.

Concerns to report: • Diarrhea

• Severe Constipation

Dressing is: Assisting a client with any aspect of dressing including putting on clothes, shoes, and non-prescription support stockings.

• Safe Procedures:

• Wash hands before client contact, don gloves.

• Discuss procedure with client.

• Remember to provide as much privacy as possible.

• Start dressing from top and work down (unless client prefers otherwise).

• When dressing a stroke client, dress the affected side first due to limited mobility.

• Safe Procedures Continued:

• Assist client in putting on each article of clothing, encouraging as much self-care as possible.
• Take dressing as an opportunity to inspect skin for reddened areas or skin breakdown.
• Help client back to a safe, comfortable position.

• Remove gloves, wash hands.

• Report any abnormalities to the office.

• Tips:

• With Alzheimer’s/ Dementia clients, only offer two choices.

• When assisting with socks, roll the socks down, inset the client’s toes, and then roll the socks back up. Encourage clients to wear non-slip socks if they don’t wear shoes.

• When assisting a weak client to dress, have the client sit down while you insert feet into undergarments and pant legs. Then, help client to stand, have something sturdy like a walker for client to hold onto, and pull up clothing quickly.

• For long sleeved garments, reach your hand in from the wrist, grasp the client’s hand and guide through. This can be done with pants also.

Exercise is: Encouraging a client to do normal bodily movement as tolerated.

Walking is considered exercise.

• Safe Procedures:

• Wash hands, before client contact.

• Discuss procedure with client.

• Encourage client to do normal body movement.

• Walk indoors or outdoors (when weather and safety permit)

• Raising & lowering arms & legs. As well as flexing & relaxing muscles.

• Safe Procedures Continued:

• Observe and ask client about pain/anxiety.

• If client becomes tired, stop and rest. Only continue if client feels up to it.

• Help client back to a safe, comfortable position.

• Report any abnormalities to the office.

• Notes:

• Prescribed exercise will be given by a therapist. We cannot prompt or assist.

• Sometimes therapists ask us to do Range of Motion, remember this is not allowed for PCPs.

• Safe Procedures:

• Wash hands before client contact.

• Check temperature of food. (Do not blow on food as this can spread germs)

• If food is too hot, wait five minutes and try again.

• Cut food into appropriate sizes as needed. Give small bites and allow time to chew.

• With stroke clients, place food on unaffected side of mouth.

• Safe Procedures Continued:

• Prompt client to chew thoroughly if necessary.

• Some Alzheimer’s/ Dementia clients can chew and swallow but must be prompted.
• When client is through eating, check mouth for food pocketing. Offer client a drink to rinse the mouth or use a Q-tip swab to remove.
• Observe client for pain/anxiety.

• Report any abnormalities to the office.

• A Touch of Care- Set the table nicely for meals.

• If client has a choking risk-contact the office.

Hair Care is: Assisting a client to wash, dry, or style hair.

• Safe Procedures for Washing:

• Wash hands before client contact, don gloves.

• Discuss procedure with client.

• If washing hair in bed-waterless shampoos are now available to make this process much easier.
• Run water at a safe temperature.

• Start with cold and add hot until a warm temperature is established.

• When turning off water, turn off hot first, then cold to prevent scalding.

• Safe Procedures for Washing Continued:

• Wet hair with water, avoiding eyes.

• If a shower nozzle is not available, a large cup can be used to pour water over the hair. (Keep towels available to dry eyes)

• Apply a non-medicated shampoo of client’s choice and gently massage it throughout hair. Repeat this step with conditioner.

• If hair is long, gather it at the back of the head and gently squeeze out excess water. Then use a towel to pat hair dry.

• Remove gloves, wash hands.

• Report any abnormalities to the office.

• Safe Procedures for Combing:

• Wash hands before client contact.

• Use a wide-toothed comb with long or thick hair. Start at the bottom of the hair and work your way up to the scalp to work out tangles easily. Comb gently, don’t apply too much pressure.

• Safe Procedures for Drying:

• After washing, offer to dry client’s hair using a hair dryer. Wash hands before client contact.
• Keep the hair dryer moving at all times and keep at least six inches from the head. Consistently check with client for comfort with the heat of the dryer.

• Safe Procedures for Styling:

• PCPs may style client’s hair as desired. This includes using pin curls, curlers, curling irons, etc. This also includes hair styles such as braiding.

• Wash hands before client contact. Discuss procedure with client.

• If you are not familiar with the style the client desires, ask for instructions.

• Follow the client’s instructions and be sure to keep all styling tools away from the client’s skin at all times.
• Ask for client’s approval before finishing.

• Safe Procedures for Brushing Teeth Continued:

• Take care not to gag client by getting the brush too far back.

• Prompt client to spit and rinse with a small amount of water, if necessary.

• Alzheimer’s/Dementia client often need to be cued like this.

• Assist client back to a safe, comfortable position.

• Clean up all supplies. Remove gloves, wash hands.

• Safe Procedures for Denture Care:

• Wash hands before client contact, don gloves and goggles.

• Ask client to remove dentures.

• Safe Procedures for Denture Care Continued:

• Take care with dentures, as they can break easily if dropped in a porcelain sink. Always fill sink with water before cleaning dentures.
• Rinse dentures thoroughly but NEVER use hot water.

• Apply denture cleaning paste to a denture brush or a soft-bristled toothbrush.
• Do Not use regular toothpaste, bleach, vinegar or soap on dentures.

• Brush all surfaces, and then rinse well. Return clean dentures to client.

• Note: Dentures are usually soaked in a cleanser overnight. Clients may also brush gums to assure cleanliness.

Mouth Care IV • Safe Procedures: Lip Care

• Wash hands before client contact; don gloves and googles. Discuss procedure with client.
• Apply moisturizer to client’s lips, either directly or with a swab like a Q-tip.

• If client’s lips are cracking, PCP should offer this task.

• Clean up supplies, remove gloves, and wash hands.

• Safe Procedures: Mouthwash

• Offer mouthwash to client as part of good oral hygiene.

• Pour a small amount into a cup and offer to client. Cue client as needed to swish and then spit. Offer water after mouthwash to rinse mouth.

• Nail Care is: Soaking, cleaning or filing a client’s fingernails or toenails when client is NOT diabetic and does not have peripheral circulatory problems.

• Trimming is NOT allowed. Foot soaks are NOT allowed.

• Check Plan of Care before performing Nail Care. Do not perform if it is not on the POC without permission from the office; it may be skilled.

• Safe Procedures:

• Wash hands before client contact, don gloves.

• Discuss procedure with client

• Fill a small basin with warm water. Soak fingernails two or three minutes; soak toenails at least five minutes.

• Safe Procedures Continued:

• Use a cloth or nail brush to gently clean under nails.

• Rinse nails in clean water after cleaning. Dry hands and/or feet thoroughly.

• Remove gloves, wash hands.

• File nails straight across to a length to allow white to show at the edge of nail. Do not leave any rough areas.

• It is good to offer SKIN CARE at this time.

• Positioning is: Assisting a client to change positions or improve comfort in a bed or chair, when client is able to identify to PCP (verbally or non-verbally) when the position needs to be changed.

• Examples:

• Helping client to roll to side

• For Client Safety: NEVER place a pillow or rolled towel under the knees of a bed bound client. This can increase the risk of blood clots in the legs and feet.

• Safe Procedures in Bed:

• Wash hands before client contact. Discuss procedure with client.

• If turning client in bed, get as close as possible to client before moving.

• Put one knee on the bed close to the client.

• If client is in a hospital bed, adjust the height to make this easier.

• You want to roll the client away from you.

• Support the client at the shoulders and at the hips, use proper body mechanics.
• Count to three and have the client assist you to help him/her roll to the side.

• Safe Procedures in a Chair:

• Wash hands before client contact.

• Position pillows as client requests.

• Position extremities if necessary. This is often needed when clients are partially paralyzed.

• Arms/ Legs

• Encourage client to assist if possible.

• Use proper body mechanics. If limb is too heavy, do not attempt; call the office.

• Do Not transfer client out of chair if transfer is skilled.

• Protective Oversight is: Staying with a client who cannot be left alone in order to prevent dangerous behaviors like falls, wandering, fire, self-harm etc.

• P.O. is generally for Alzheimer’s or Dementia clients. Do not mark it unless it is on your Plan of Care.

• Do NOT leave the client alone without authorization from the office.

• Safe Procedures:

• Keep client within your sight at all times.

• Why Protective Oversight is needed must be documented on timesheet.

• Work to not upset the client. Agree whenever possible. An activity is okay if it will not cause harm to the client or someone else.

• Safe Procedures Continued:

• Use Diversion Techniques:

• Distraction: You do anything to get their mind busy with something else. Starting to sing a song, ask them if they like chocolate, etc.

• Gentle Guidance: You don’t ASK, you GUIDE. Example: “This is a nice shirt, and you look great in blue.”

• Therapeutic Fibbing: You “fib.” Example: “Oh, Mrs. White, please may I stay? I locked my keys in the car, and I am waiting for my husband to come and get me.”

• Safe Procedures Continued:

• Diversion Techniques Continued:

• Validation: You are there for support. Don’t say, “It’s ok” because it isn't. And don’t say, “I understand,” because you don’t. Say “this must be hard for you.” etc.

• Reassurance: You are the client’s life preserver when he/she is dealing with Alzheimer’s or Dementia. Make the client feel safe and competent. Celebrate successes and minimize mistakes.

• Avoid aggression. Clients can get angry and physical at times. Work to avoid this by keeping client calm and happy with the techniques listed above. Call the office if client become aggressive with you. Do not attempt to restrain.

• Unskilled Respiratory Care is: cleaning of equipment; replacing client’s oxygen tubing; cleaning nasal cannula; assisting with assembly and cleaning of nebulizer; filling oxygen water bottle.

• Safe Procedures Oxygen:

• Never adjust oxygen flow or fill travel containers. Wash hands beforehand.

• Nasal Cannula: Wash once or twice per week with liquid soap and rinse thoroughly. Replace every two to four weeks and following a cold or other illness.

• Humidifier Bottle: Wash with soap and warm water between each refill. Air dry the bottle before filling with sterile or distilled water. Be sure the bottle is threaded properly, or the client will not get any oxygen.

• Safe Procedures Oxygen Continued:

• Oxygen Concentrator: daily care; unplug the unit and wipe down with a damp cloth. Then dry and plug it back in. The air filter should be cleaned at least twice a week according to manufacturer instructions.

• Safe Procedures Nebulizer:

• Wash hands before task.

• Assist client in assembling nebulizer if client can direct you. Do not pour medication into the nebulizer; client must do this task.
• Clean the nebulizer cup and mouthpiece with warm water and allow to air dry after each use.

• Daily Care: wash the nebulizer cup and mouthpiece in warm, soapy water, rinse thoroughly, allow to air dry.

• Do not wash the tubing that connects the nebulizer to the air compressor.

• Air Compressor: Cover with a clean cloth when not in use. Wipe with a damp cloth to clean. Do not put the compressor on the floor for use or storage. Check the air compressor’s filter and replace as directed by the manufacturer.

• Skin Care is: Applying non-prescription lotions, creams, solutions, or powders to a client’s skin. This promotes skin health and prevents breakdown and basic first aid. Skin care must be preventive rather than therapeutic.

• Examples: Applying lotion after client’s bath, applying powder to skin before dressing, etc.

• Safe Procedures:

• Wash hands before client contact, don gloves. Discuss procedure with client.
• Inspect skin surface for reddened areas or skin breakdown.

• Wash skin as needed.

Skin Care II • Safe Procedures Continued:

• Apply lotion into any requested areas, unless this causes pain or discomfort to the client. (Never perform on client with blood clots.)
• Apply powder to any requested areas. Remove gloves, wash hands.

• Make sure if client is bedbound, that linens are as wrinkle-free as possible, to prevent bed sores.

• A Touch of Care

• Skin care is a great way to break the “touch” barrier with a client. If you know a client needs more personal care, but he/she is resistive, start with lotion on the hands or feet to help the client get comfortable with being touched.

• Transfer is: Assisting a client from one position to another:

• Bed to wheelchair

• Sit to stand

• Client must have sufficient balance and strength to reliably stand and pivot and assist with the transfer to some extent.

• Client may use adaptive equipment when client and PCP are trained in its use.

• Transfer is NOT: Transportation.

• Use an upright, neutral working posture and proper body mechanics.

• Bend at your legs, not your back. Use your legs to do the work.

• When assisting people to move, always face them and maintain eye contact if possible.
• Tighten your stomach muscles.

• Do not twist your back when turning. Pick up your feet and pivot your whole body in the direction of the move.

• Try to keep the client, as well as any equipment or supplies, close to your body.

• Keep your “handholds” between your waist and shoulders.

• “Handholds” are where you are holding the client.

• Examples: Under the arms; at waist with a gait belt.

• Move the client towards you, not away from you.

• Use a wide balanced stance with one foot slightly ahead of the other. Feet should be at least shoulder width apart.

• Lower the client by bending your legs, not your back. Return to a standing position as soon as possible.

• Safe Procedures:

• Wash hands before client contact. Discuss procedure with client.

• Get the client ready to transfer.

• Have the client sit up. Have the client hang legs off bed side before standing up. Have the client scoot forward with buttocks at the edge of the bed or chair.
• Prepare for the transfer.

• Check that wheelchair brakes are locked. Check that pathway is clear. Check that client is wearing non-slip footwear. Place the receiving surface on the client’s strong side.

• Safe Procedures Continued:

• Sit to Stand:

• Have the client scoot to the edge of the bed or chair and position the feet directly under the body. Ask client to position hands on arm rest in order to push up to stand when it’s time.

• Grasp the client appropriately. Tell the client to stand on the count of three. Count 1, 2, 3, stand. Do not lift the client. If the client cannot assist to stand, we cannot do the transfer.

• Assist the client to stand and pivot as necessary. Turn with your feet, not your back when pivoting.

• Safe Procedures Continued:

• Stand to Sit:

• Keeping hold of the client, pivot client so that buttocks face the receiving surface and legs are touching it.

• Client should bend towards you to sit down, and you should bend your knees to assist in lowering client to chair.

• Do not bend at your back.

• Client may reach back and use arm rests to help in lowering.

Can A PCP Perform It? Is it on the Plan of Care?

Know

Licensure

When Personal Care is NOT on the POC • Client asks for/needs a Personal Care task.

1. •

•

PCP checks, and that task is not on the Plan of Care. PCP contacts office for approval.

PCP believes the task is Unskilled.

PCP performs approved Personal Care task.

Touch of Care monitors the need for Personal Care,

adds task to Plan of Care.

• PCP may not accompany • Medicaid clients for the sole purpose of companionship.
• PCP may not provide ANY skilled personal care in • conjunction with the accompaniment.

• PCP may not transport

client.

PCP may not assist clients with ambulation if clients cannot balance and bear weight.

PCP may not assist with adaptive equipment if the client AND PCP are not

trained in its use.

• PCP may not bathe when the client has open wounds or potential for infection.
• PCP may not bathe if skilled skin care, skilled transfer or skilled dressing are involved.

• PCP may not bathe if the client has any skilled skin care needs that will need attention before, during or

after bath.

• PCP may not perform any catheter care other than emptying catheter bag.

• PCP may not perform bladder care if skilled skin care, skilled transfer, or skilled dressing are in-

volved.

• PCP may not assist with • ostomy care unless it is directed by client.

• PCP cannot perform any

ostomy care that involves • skilled skin care or requires

skilled observation or reporting to a nurse.

• PCP may not perform digital stimulation, insert suppositories or give

enemas.

PCP may not assist with application of prescription TED hose or ACE bandages.

PCP may not assist with dressing if skilled skin care, or skilled transfer are

involved.

• PCP may not assist with any • exercise except for normal bodily movement, as TOLERATED, by the client.

• PCP may not assist with or model any prescription exercises. PCP may not • prompt these exercises.

• PCP may not perform

passive range of motion.

PCP may not assist when the client cannot independently chew and swallow without difficulty or if there is a high risk of choking.

PCP may not assist with

syringe, tube or IV feeding.

• PCP may not assist with hair care when skilled skin care, skilled transfer, or skilled dressing is involved.

• PCP may not shampoo client’s care with prescription shampoo.

• PCP may not cut, perm, or

color client’s hair.

• PCP may NOT perform any • medication related tasks for prescription or OTC medications unless

medications have been • pre-selected and placed in

medication minders.

• PCP may not touch pills or

cut pills or place them in • medication minders.

• PCP may not apply

prescription creams.

PCP may not perform if the • client is unconscious, has difficulty swallowing, or is at risk for choking/aspiration.

PCP may not perform if there is an injury or disease of the face, mouth, head, or neck.

PCP may not perform if • skilled skin care, skilled transfer, or skilled dressing

is involved.

PCP may not perform ANY nail care for clients who are Diabetic, who have clotting disorders, who take blood thinners or who have other peripheral circulatory problems or loss of sensation.

PCP may not trim nails.

• PCP may not perform if • client is unable to identify to the PCP when the position

needs to be changed.

PCP should not leave P.O clients alone. PCPs should keep clients within sight at

all times, or as much as

• PCP may not perform postural drainage, cupping, or nasal endotracheal, or

tracheal suctioning.

• PCP may not perform when skilled skin care, skilled • transfer, or skilled dressing

is involved. •

possible. •

PCP may not perform if any skilled care is involved.

PCP must be trained in

oversight and diversion

oxygen flow.

techniques for specific client conditions.

• PCP may not perform when • skilled skin care, skilled transfer, or skilled dressing •

is involved.

PCP may not perform • therapeutic skin care.

PCP may not perform when skin is broken, or when any chronic skin problems are •

active.

PCP may not assist with adaptive equipment if the client AND PCP are not trained in its use.

PCP may not assist if client

does not have sufficient

solutions or powders.

balance and strength to reliably stand and pivot and assist with the transfer to

some extent.

Dressing

(before/after)

Transfers

Exercise Ambulation (if walking to destination)

Med • Med Minders Required

Prompt (Can open med minders) • Cannot Open Over the

Counter Bottles/prescriptions.

Nail • No Trimming Care • Filing Only

Accompaniment:

Going with a client somewhere.

Examples:

Shopping, Doctor

Helping a client get more comfortable.

Examples: Turning in bed,

placing a pillow.

Protective Oversight:

Staying with a client to prevent harm.

Examples: Alzheimer’s

client cannot stay alone.

• Purpose: to inform you about the client you will see and to assign the tasks you should perform for the client.

• Plans of Care are on the AxisCare App.

• Important Notes:

• It is YOUR responsibility to read the Plan of Care for each of your clients.

• You need to read each Plan of Care carefully, and you should re-read it frequently.

• The tasks you perform for each client should line up with the tasks on each client’s Plan of Care.

• If you feel that a client’s Plan of Care should be updated, contact the office promptly.

• When you review a Plan of Care, read the directions and make sure you understand where the client lives.
• Ask questions about a client’s location before it’s time for you to be at the visit.
• Read ALL the notes on the Plan of Care. They are important. Make sure you know which Visit Type your visit will be.
• Plans of Care are developed with the client based upon their needs and what is

authorized by their payor source.

• It is necessary to follow the Plan of Care to give clients the quality of care they deserve.

• If a client needs a service that is not assigned on the Plan of Care, call the office for task approval.
• If the task is appropriate, the office will approve it for the client.

• Then, if the task is needed again, we can add it to the Plan of Care.

• Do NOT perform tasks for a client if they are not on the Plan of Care without approval from the office.

• If a client repeatedly refuses or doesn't need a task, notify the local Client Care Coordinator.

• We can remove the task or address the issues involved.

• We want the Plan of Care to accurately reflect the client’s needs. Let the office know when changes are needed.

• Relative Providers will have a separate Plan of Care.

• Relative Providers must provide only Personal Care.

• Relative Providers cannot do any homemaking tasks under Touch of Care.

• Pay close attention to Personal Care and Homemaking Visits.

• Follow your Plan of Care. If you are not sure if you should do a Personal Care or Homemaking visit, call the office.

• Other home care workers will occasionally come to clients’ homes while we are there.

• Ask, “Are you a C.N.A?”

• If the person is a C.N.A., and the client is a Medicaid client, we will need to clock out during the C.N.A’s visit.

Call the office if a C.N.A arrives, and you are unsure what to do.

• The Client Care Coordinator will try to coordinate with the Home Health or Hospice agency to prevent this from occurring too frequently.

Electronic Visit Verification (EVV)

Federal and State regulations require the utilization of Electronic Visit Verification.

Touch of Care uses a web-based software, AxisCare, to meet Federal and State regulations.

AxisCare has a free APP available to staff.

Time sheets are generated through the Axis Care App.

Touch of Care’s Server Number is 9911.

AxisCare Mobile Caregiver Guide

Use AxisCare Mobile to clock in and out, check your schedule, enter visit details, find directions to your client’s home and much more!

• Be aware that your view may vary from the images provided, depending on your agency’s settings.

1.Open the App Store (iPhone) or Play Store (Android)
2.Search for ‘AxisCare’ (the logo looks like the image to the right) 3. Download the app (no charge)

1.Activate Your Account (if you haven't already) Open the mobile app and type in your agency’s server number. Server number is 9911.

Click the “Next” button
Enter the email address associated with your AxisCare profile (Contact your agency if you are unsure of this information)
You will be sent an email to the email address entered. Enter the activation code into AxisCare (you may also be asked for your date of birth and zip code, depending on system security settings)
Set your password
104

Log In: Enter your username: firstnamelastname (i.e. johndoe)
Enter Password: Enter the password you created when activating your account.

Home Screen n@example.com)

The Home Screen shows current visits that are in session as well as upcoming visits. Each visit shown includes the following details:

Date and Time of Visit
Clock In/Out Time
Client’s address and ‘Open In Maps’ link to open address in Google Maps
A ‘Start Travel Time for This Visit’ option may also be shown. Start this timer when you leave for your next visit to calculate inter-visit travel time.
A ‘Call’ option may also be shown beside the client’s name which you may use to reach out to the client.

Click on visits to clock in and out, complete ADLs and notes, and enter breaks, mileage, expenses, and travel time.

Your agency may also set up a geo-fence that will only allow you to clock in/out once you are in a specific vicinity of the client’s home. If you are outside of the geo-fence you will not be able clock in/out.
Clock in/out button can only be clicked on once. Clock in/out time cannot be changed once recorded.

Accept, decline, or dismiss each open visit.
Once ‘Request’ has been chosen, you may be automatically assigned to the shift OR your agency may need to finalize your acceptance depending on their preferences (contact your agency for more information).

Click on ‘See More’ to view more available visits.

Click on the visit to see visit details and to record ADLs, notes, breaks, mileage, expenses, and travel time.

The Chat tab is where you will receive and respond to direct messages from the office. In addition to receiving a push notification, a notification with a number will show above the Chat widget when you have unread messages. Keep in mind, chats are not monitored 24 hours a day. Important communication with the office i.e. late for visit, calling in, important change in condition, etc. must be called in to the office. If it is after hours, leave a message. The on-call line is monitored 24/7.

Click on the three vertical dots at the top right of your screen to see additional AxisCare mobile app options:

Fit for Duty COVID-19 Symptom Screener

After clicking on "Clock In" at the start of a visit, you may be prompted to answer two questions related to the COVID-19 outbreak (depending on your agency's settings): 107

1.Are you currently feeling unwell or suffering from any symptoms such as fever, chills, cough, or shortness of breath?

2.Within the last 14 days, have you been in direct contact with anyone who has been diagnosed as infected with, or is suspected to have been exposed to coronavirus/COVID-19?

Here are a few reasons why you may be having trouble clocking in/out: You are trying to clock in/out too early or late

Your agency may have a clock in/out window set which will not let you clock in/out unless you are so many minutes away from your shift’s start/end time. Check with your agency to see what your clock in/out window is set to.

You are trying to clock in/out too far from the home
Make sure you are inside the home when you attempt to clock in/out.

You do not have a visit scheduled.
If you think there may be a scheduling mistake, please contact your agency to ensure that you are in fact scheduled for a shift

You have not completed your Activities of Daily Living
Your agency may require you to check your ADLs off + enter visit notes before clocking out. If this is the case, be sure to mark all activities as either complete or incomplete before attempting to clock out.

Touch of Care’s direct care staff will be paid for drive time between client homes.

Touch of Care monitors drive time amounts. Drive time is actual. Excessive drive time

will need to be explained.

• Perform all tasks As Assigned

• Check all tasks you perform.

• Remember to note why tasks are not completed.

• R-Refused

• NT-No Time

• Each visit should have comments about the client’s condition

• Examples:

• “Mr. Moore fell on 4/13. He is fine, just sore and bruised.”

• “Mrs. White has not been following her diabetic diet. She said her blood sugar levels are high.”
• “Joe is doing poorly. He has been unsteady on his feet and very weak.”

• Purpose: To document the use of cash, debit, credit cards, or blank checks given to Personal Care Providers by clients.

• Requirements:

• Return receipt and change to client. (CTR is your receipt, client signature verifies that you used funds correctly.)
• Fill out all fields; include the amount spent.

• Turn in all CTRs each Monday.

• CTRs are important protection for you and Touch of Care.

• Handling large amounts of cash puts both you and Touch of Care at risk.

• Touch of Care employees do not do banking for clients.

• Touch of Care does not get cash back from Debit/Credit Cards or personal checks.

Critical Incidents and

Occurrences

Death

Serious Illness or Injury

Medication Management Problems (if there is an adverse effect)

Damage to a Client’s Property/Theft

Other High-Risk Issues: Issues that don’t yet constitute a Critical Incident but may

Do so in the future, such as suicide threats, environmental hazards, and self-injury.

Report to Client Care Coordinator by phone.

Touch of Care will report to Case Manager by phone.

Client Care Coordinator will complete the Critical Incident Form.

Suspicious Death

Neglect

You are a mandatory reporting.

Report to your Client Care Coordinator.

The Client Care Coordinator will notify the Agency Manager

The Client Care Coordinator will also notify the Case Manager

The Client Care Coordinator will notify Adult Protection Service,

if appropriate

.

Touch of Care will follow all federal and state laws pertaining to the Health Insurance Portability and Accountability Act's Privacy rule. This law requires that all Protected Health Information (PHI) be safeguarded. Touch of Care will not release Protected Health Information without proper authorization or as required by law.

To adhere to this policy, all Touch of Care employees will comply with the following procedures.

Posted:

Touch of Care will post the Notice of Privacy Policy in the reception area of the office for easy access.

Distributed:

Touch of Care will distribute the Notice of Privacy Policy to all employees and clients.

Original Training:

All employees will be required to complete Privacy Training. This training requires all employees to understand, acknowledge and promise to follow Touch of Care's Privacy Policy & Procedures.

Annual Review:

All employees review Privacy Training at least once annually.

Authorization

Touch of Care will receive a signed authorization from all clients, giving permission for Touch of Care to share non-essential PHI. In non-essential situations, clients can designate with whom PHI may be shared. This authorization will remain in effect as long as the client receives services from Touch of Care. This authorization can be revoked or revised by contacting the Privacy Officer.

Giving

Touch of Care's Administrative Staff:

Touch of Care will give all administrative staff access to the Electronic Medical Record. The electronic medical record contains basic client information including name, address, phone number, hours of service, etc. The information included in the electronic medical record will be used only to facilitate services to Touch of Care’s clients.

Touch of Care’s Direct Care Staff:

Touch of Care will give all Direct Care Staff access to their Clients’ Basic information through the AxisCare App. Basic client information including name, address, phone number, etc. The App will include the services that each client needs, the frequency and special instructions for each task, and the special needs and conditions of each client.

Case Managers:

Touch of Care will give each SEP a copy of each Medicaid client’s Plan of Care if requested. Touch of Care will provide the Case Managers information regarding change of condition.

Physicians:

Touch of Care will contact a client’s physician with information about

client changes in condition that warrant medical attention.

Home Health or Hospice Agencies:

Touch of Care will give Home Health or Hospice Agencies information about a client’s schedule and tasks to be performed.

Touch of Care will contact Home Health or Hospice Agencies with information about client changes in condition that warrant skilled care.

Family Members:

Touch of Care will only give information about a client to family members with authorization from the client.

Receiving:

Touch of Care Administrative Staff:

Touch of Care will receive copies of Advanced Directives for clients from

physicians, hospitals, or family members.

Touch of Care’s Direct Care Staff:

Touch of Care will receive information about changes in client condition from all Direct Care Staff.

Case Managers:

Touch of Care will receive a referral from a Case Manager for each Medicaid client. This referral will contain client PHI. The referral will enable Touch of Care to make contact with the client and to facilitate services.

Touch of Care will receive Prior Authorization Requests from case managers to designate approved hours of service.

In the event that a client leaves home to go to an inpatient facility, Touch of Care will receive notice from the client’s Case Manager.

Touch of Care will receive client information from each Case Manager related to the provision of care.

Home Health or Hospice Agencies:

Touch of Care will receive a referral from Home Health or Hospice Agencies for Private Pay clients. The Home Health or Hospice Agency will give Touch of Care the client’s name and phone number. This referral will enable Touch of Care to make contact with the client and to facilitate services.

Touch of Care will receive client information from Home Health or Hospice Agencies related to the provision of care.

For IHSS clients, Touch of Care will receive a Plan of Care from Home Health or Hospice Agencies to prevent duplication of services.

Family Members:

Touch of Care may receive client information from family members related to the provision of care.

Documents and Electronic Medical Record:

Direct Care Staff’s Responsibility

All Direct Care staff are responsible for keeping any client documentation private. Direct Care staff must keep their passwords private for the Electronic Medical Record App.

Do not make copies of client-related documents at any time.

Administrative Staff Responsibility:

All administrative staff are responsible for keeping any client documents secure.

Documents will be kept secure and out of public view at all times.

Keep filing baskets behind counter, under ledge and lock up the filing baskets nightly.

Lock Client Record Filing Cabinets nightly.

Lock Personnel Record Filing Cabinets nightly.

Reception Area:

Administrative Staff Responsibility

All administrative staff are responsible for keeping all client PHI confidential.

Computers:

Close documents that contain client PHI at all times when not in use.

Set screen savers to come on after 30 seconds.

Close documents when non-employees are present.

Keep Password Protection in place.

Log off computers when leaving the work area.

Copy and Fax Machines:

No public access.

Work on all projects containing client PHI using the area behind the counter.

Other Administrative Offices:

Administrative Staff Responsibility:

All administrative staff are responsible for keeping all client PHI confidential.

Lock Offices:

Each administrative office containing client PHI will be locked nightly.

Computers:

Make sure the computer screens are not visible to the public.

Close documents that contain client PHI at all times when not in use.

Set screen savers to come on after 30 seconds.

Close documents when non-employees are present.

Keep Password Protection in place.

Log off computers when leaving the work area.

Out of View: All documents containing PHI

Phone Calls:

All Direct Care Staff are responsible for keeping all client PHI confidential.

Client’s Home

Only make phone calls related to a client. Only discuss a client’s PHI from that client’s house or from a secure locat

Administrative Staff Responsibility:

All administrative staff are responsible for keeping all client PHI confidential.

Non-employees in the Office

Do not conduct phone calls related to clients or discuss client PHI in the presence of non-employees.

Make phone calls to discuss client issues with Direct Care Staff to the home of the client in question only.

Client Discussion

Direct Care Staff Responsibility

All Direct Care Staff are responsible for keeping all client PHI confidential.

General

Only discuss clients for the provision of care.

In the Office

Ask administrative staff members to speak privately about client concerns. Do not discuss clients with any non-employee present.

Outside the Office

Do not discuss client PHI with any non-employee unless it is essential to provision of care.

Administrative Staff Responsibility

All Administrative Staff are responsible for keeping all client PHI confidential.

General

Only discuss clients for the provision of care.

In the Office

Do not discuss any client PHI with any non-employee present.

Do not discuss client PHI with any non-employee unless it is essential to provision of care.

Outside of Office

Do not discuss any client PHI with any non-employee unless it is essential to provision of care.

Touch of Care’s Privacy Officers:

Delta: Kyle Martinez

We are very happy to welcome you to Touch of Care. Thank you for joining us! We want you to feel that your association with Touch of Care will be a mutually beneficial and pleasant one.

You have joined an organization that has established an outstanding reputation for quality of service. Credit for this goes to every one of our employees. We hope you will find satisfaction and take pride in your work here.

This Manual provides answers to most of the questions you may have about Touch of Care's benefit programs, as well as the company policies and procedures we abide by — our responsibilities to you and your responsibilities to Touch of Care. If anything is unclear, please discuss the matter with your manager. You are responsible for reading and understanding this Employee Manual. In addition to clarifying responsibilities, we hope this Employee Manual also gives you an indication of Touch of Care's interest in the welfare of all who work here.

The information included in our Employee Manual may change periodically. The Employee Manual is not a contract and you should therefore expect that policies, procedures and benefits will change from time to time. Every effort will be made to keep you informed through suitable lines of communication, including notices through newsletters and paycheck stuffers.

Compensation and personal satisfaction gained from doing a job well are only some of the reasons most people work. Most likely, many other factors count among your reasons for working — pleasant relationships and working conditions, career development and promotion opportunities, and health benefits are just a few. Touch of Care is committed to doing its part to assure you of a satisfying work experience.

We extend to you our personal best wishes for your success and happiness at Touch of Care.

Sincerely,

The Martinez Family

As a member of Touch of Care's team, you will be expected to contribute your talents and energies to improve the environment and quality of the company, as well as the company's services. In return, you will be given opportunities to grow and advance in your career.

Touch of Care is dedicated to two standards:

1. To provide our clients with the best quality service.

1. To provide you with wages and benefits comparable to others doing similar work within the industry and within the region.

At Touch of Care, we always put safety first. We believe it is our duty to provide you with as safe a workplace as we possibly can.

This Employee Manual is an important document intended to help you become acquainted with Touch of Care. This Manual will serve as a guide; it is not the final word in all cases. Individual circumstances may call for individual attention.

Because the general business atmosphere of Touch of Care and economic conditions are always changing, the contents of this Manual may be changed at any time at the discretion of Touch of Care.

Please read the following statements and sign below to indicate your receipt and acknowledgment of the Touch of Care Employee Manual.

• I have received and read a copy of the Touch of Care Employee Manual. I understand that the policies, rules and benefits described in it are subject to change at the sole discretion of Touch of Care at any time.

• I further understand that my employment is terminable at will, either by myself or Touch of Care, regardless of the length of my employment or the granting of benefits of any kind.

• I understand that no contract of employment other than "at will" has been expressed or implied, and that no circumstances arising out of my employment will alter my "at will" employment relationship unless expressed in writing, with the understanding specifically set forth and signed by myself and the President of Touch of Care.

• I am aware that during the course of my employment confidential information concerning employees, clients, illnesses and employment decisions will be made available to me, I understand that this information is confidential and agree to maintain such matters in confidence in accordance with HIPAA’s Privacy Act. I agree to abide by this policy at all times.

• I understand that, should the content be changed in any way, Touch of Care may require an additional signature from me to indicate that I am aware of and understand any new policies.

• I understand that my signature below indicates that I have read, understand and agree to the above statements and have received a copy of the Touch of Care Employee Manual.

______________________________________ _________________________

Employee's Signature Date

______________________________________ __________________________

Manager's Signature Date

The task of handling personnel records and related personnel administration functions at Touch of Care has been assigned to the Payroll Office. Questions regarding insurance, wages, and benefits may be directed to the Payroll Office.

Keeping your personnel file up to date can be important to you with regard to pay, deductions, benefits and other matters. If you have a change in any of the following items, please be sure to notify the Payroll Office as soon as possible:

1. Legal name

2. Home address

Coverage or benefits that you and your family may receive under Touch of Care's benefits package could be negatively affected if the information in your personnel file is incorrect.

Since Touch of Care refers to your personnel file when we need to make decisions in connection with promotions, layoffs and recalls, it is to your benefit to be sure your personnel file includes information about completion of educational or training courses, outside civic activities, and areas of interest and skills that may not be part of your current position here.

You may see information that is kept in your own personnel file if you wish, and you may request and receive copies of all documents you have signed.

At the time you are hired, you are classified as full-time, part-time or temporary and are also told whether you qualify for overtime pay. Unless otherwise specified, the benefits described in this Manual apply only to full-time employees. All other policies described in this Manual and communicated by Touch of Care apply to all employees, with the exception of certain wage, salary and time off limitations applying only to "non-exempt" (see the definition that follows) employees. If you are unsure of which job classification your position fits into, please ask your manager.

An employee who has successfully completed the Introductory Period (See the Employment Policies section for definition) of employment and who works at least thirty (30) hours per week is considered a full-time employee.

An employee who works less than a thirty (30) hour work week is considered a part-time employee. If you are a part-time employee, please understand that you are not eligible for benefits described in this Manual unless otherwise specified, or to the extent required by provision of state and federal law.

From time to time, Touch of Care may hire employees for specific periods of time or for the completion of a specific project. An employee hired under these conditions will be considered a temporary employee. The job assignment, work schedule and duration of the position will be determined on an individual basis.

Normally, a temporary position will not exceed six (6) months in duration, unless specifically extended by a written agreement. If you are a temporary employee, please understand that you are not eligible for benefits described in this Manual, or to the extent required by provision of state and federal laws.

At the time you are hired, all employees are classified as either "exempt" or "non-exempt." This is necessary because, by law, employees in certain types of jobs are entitled to overtime pay for hours worked in excess of forty hours (40) per work week. These employees are referred to as "non-exempt" in this Manual. This means that they are not exempt from overtime pay. Overtime MUST be requested and approved by management before the hours are worked.

Exempt employees are executives, managers, officers, owners and others whose duties and responsibilities allow them to be "exempt" from overtime pay provisions as provided by the Federal Fair Labor Standards Act (FLSA) and any applicable state laws.

Whether you are a new hire or a former employee returning to Touch of Care, you may feel a little strange in your new surroundings. This is a normal feeling and is expected. Your fellow employees, especially your manager, want to help you get off to a good start. Feel free to ask them for help concerning anything you don't understand.

One of the first things you should do is carefully read this Manual. It is designed to answer many of your questions about the guidelines for working at Touch of Care, what you can expect from Touch of Care, and what Touch of Care expects from you.

The first day you report to work is your "official" anniversary date. Your anniversary date is used to compute various conditions and benefits described in this Manual.

All employment and compensation with Touch of Care is "at will" which means that your employment can be terminated with or without cause, and with or without notice, at any time, at the option of either Touch of Care or yourself, except as otherwise provided by law.

Our regular office hours are 8:00 a.m.to 12:00 p.m. and 1:00 p.m. to 4:30 p.m. Monday through Friday. Our offices are closed on all major holidays.

Touch of Care’s Administrative staff completes the schedule each week, with the exception of IHSS cases which may be scheduled by the client. All requests for time-off and schedule changes must be made by Monday at 2:30 p.m. for the coming week, with the exception of IHSS attendants who are required to notify the office with two (2) week notice. Approval of time off requests is dependent on service area and client need.

Relative only provider schedules are determined initially with the agency and client; if there are any changes the relative only provider must notify the agency. Schedules are available Friday after 2:00 p.m. via AxisCare. If using Telephony, paper schedules must be picked up between 2:00 p.m. and 4:00 p.m. on Friday. Schedules must be picked up during this timeframe. If you are unable to come to the office during this time, it is your responsibility to make arrangements with the office staff.

The success of Touch of Care depends upon the quality of the relationships between Touch of Care, our fellow employees, case managers, physicians, our clients, client visitors, and the general public. Our clients' impression of Touch of Care and their interest in doing business with us is greatly formed by the people who serve them. In a sense, regardless of your position, you are Touch of Care's ambassador. The more goodwill you promote, the more our clients will respect and appreciate you, Touch of Care and Touch of Care's services.

When working as a team in a client’s home, Touch of Care often uses a Communication Book to allow staff to communicate with each other, other agencies, and family members. Please ensure that comments in these books are tactful and professional in nature and pertain to the provision of care.

Here are several things you can do to help give clients a good impression of Touch of Care:

Act competently and deal with clients in a courteous and respectful manner.

Maintain a professional relationship with each client rather than a personal relationship.

Address clients by their respective titles (Mr., Mrs., Ms.) unless the client asks to be addressed in a different manner.

Do not discuss personal problems of any kind.

Display consideration and respect when speaking with, caring for, or referring to clients.

Show sensitivity regarding clients’ possessions and privacy by saying such things as “May I come in?” or “Do you mind if I move this?”

Direct any client concerns to the office.

Take great pride in your work and enjoy doing your very best.

These are the building blocks for your and Touch of Care's continued success. Thank you for adding your support.

Employees shall only be present in a client’s home when the client is present as well unless approval is received from the office in advance. If the client is not home, or it the client has to leave before the end of the employee’s shift, the employee shall call the office for direction.

All employees must report significant events and/or changes in client conditions to the office verbally as soon as they learn of the event or condition change. Reports must be made before the end of the employee’s visit with the client involved.

Examples of significant events include: missing clients, hospital visits or 911 calls, suspected abuse or neglect, serious injury or illness, suicidal tendencies, medication errors (missed meds, extra meds taken), falls, possibility of needs not being met by the Plan of Care, increase in confusion or weakness and any other noticeable change in condition.

If an employee has any problems or concerns regarding clients or their families, the employee shall contact the office. Employees shall not discuss client complaints, employment matters, or agency personnel disputes with clients. These matters shall be directed to the office.

Touch of Care has adopted a list of Written Notice of Home Care Consumer Rights as part of its agency policies and procedures and its Licensure compliance which outlines the rights of our clients. All employees are expected to comply with this policy and procedure. A copy of the Written Notice of Home Care Consumer Rights is provided in the Touch of Care Training Manual. Employees will be in-serviced upon hire and annually regarding this policy.

IHSS clients have additional rights, afforded by the IHSS program.

Employees shall not accept keys from clients for any reason. Employees shall not have in their possession any key belonging to a client, except during a visit. When the visit ends, any and all keys must be returned to the client.

At the client’s discretion, a hide-a-key or key lockbox outside their home so that employees can enter for visits. Employees shall notify Touch of Care of any hide-a-keys, lockboxes, or key codes so that they information can be added to the client’s Plan of Care. Employees shall always knock and wait for a response before using a hide-a-key or lockbox key as a matter of respect for the client’s home and privacy.

Employees have an emergency guide in each client’s home inside the client’s Touch of Care Client Handbook. This Handbook contains emergency contact information on the back page, and it is usually kept on a client’s refrigerator. All employees should check for this handbook in the client’s home and be familiar with its location in the event of an emergency.

In the event that a client is experiencing a health emergency, employees shall follow the following procedure:

Employees shall not accept gifts, tips, or loans of any kind from clients, their families or any other person encountered while on duty. If a client or family member tries to give you a gift, tip or loan, you should report this to the office staff who will discuss the appropriate action with the employee and the client and/or responsible party.

No employee shall willingly be present in a client’s home where known illegal activities are taking place. If an employee becomes aware that a client is engaged in any illegal activity during his/her visit, the employee shall leave the client’s home and contact the office for direction.

Employees shall not perform pet care of any kind for any client unless written approval is received from management in advance. It is each employee’s responsibility to act responsibly and safely when working around client’s pets, keeping in mind that pets are more protective when their owners are ill. Employees shall not play with, pet, or walk pets. If an employee feels unsafe near a pet, the employee shall contact the office for direction.

In certain situations, depending on the payor source, Touch of Care may approve minimal pet care if it is deemed to be safe for employees to perform. If pet care has been approved, it will be listed on the Plan of Care.

Generally, pets must be restrained at the beginning of each visit. Employees should notify their supervisor if they encounter unrestrained pets upon arriving at a client’s home.

Employees shall not purchase alcohol for, or serve alcohol to, any client at any time. Alcohol can interact with our client’s medications and can also make them more prone to falls. This creates a safety hazard for the client as well as the employee.

Clients who use marijuana are instructed by Touch of Care not to use the marijuana immediately prior to or during an employee’s visit and to provide adequate ventilation in the areas of the home in which agency services will be rendered. If a client is in violation of this policy, the employee shall call the office for directions.

Employees shall not purchase items from clients. If a client or family member tries to sell an item of property to an employee, the employee shall report this to the office staff who will discuss appropriate action with the employee and the client and/or responsible party.

Touch of Care’s direct care staff shall work only within the Colorado Licensure rules regarding duties of Personal Care Providers when caring for Touch of Care’s clients, regardless of their level of skill and/or training. Employees can assure compliance with this rule by following their Plan of Care, and their Touch of Care training manual.

IHSS Attendants will provide services as instructed on the Client-Specific Plan of Care and as trained by the client or authorized representative and as validated by the IHSS Healthcare Professional.

It is inappropriate for any employee to advise clients regarding medication management, health conditions, financial decisions, or other personal decisions of any kind. Employees can assist clients by notifying the office of the client’s needs and/or concerns. The office can assist the client in accessing appropriate community resources, which can aid them in making these types of decisions.

Neither employees nor their friends or family members shall solicit clients. Offering products or services to a client, other than the services provided by Touch of Care during scheduled hours, is prohibited. Distribution of literature and fundraising are not permitted at any time in a client’s home.

No Touch of Care employee shall manage a client’s finances for any reason. Examples of financial management include:

Balancing checkbooks

Writing Checks for clients or allowing a client to make a check payable to the employee.

Carrying large amounts of cash for clients (over $100)

Paying bills on behalf of the client

Banking or withdrawing cash from an ATM.

Requesting cash back on purchases in order to take spending money back to a client.

Accepting guardianship, conservatorship or power or attorney for any client

Employees shall not use client’s computers for any reason.

If shopping is listed on a client’s Plan of Care, employees may shop for clients at local stores. Shopping should be limited to 1 or 2 times weekly.

Any time an employee obtains items for a client, he/she is responsible to complete a Client Shopping Record, regardless of whether or not funds are exchanged. This policy is for the protection of the employee, the client, and the agency. Employees are prohibited from keeping a client ATM/Food Stamp card, change, or receipts past the end of the visit in which shopping was performed. These items must be returned to the client immediately.

Medication errors must be reported to the office immediately upon being discovered. Failure to prompt meds according to the plan of care, dropped meds and meds taken incorrectly all constitute medication errors. The employee should contact the office for direction on how to proceed once a medication error has occurred.

Many of our clients use prescribed oxygen to breathe. However, it is very dangerous when people use oxygen while smoking. Employees shall adhere to the following procedure when a client (or anyone else in the client’s home) smokes with oxygen on:

Ask the client to turn the oxygen off while smoking or to stop smoking.

If the person refuses to stop smoking or turn off the oxygen, promptly leave the client’s home and contact the office from the nearest available phone to report the situation.

HIPAA’s privacy rules prohibit employees from continuing to have contact with Touch of Care clients after their relationship with Touch of Care has ended unless these relationships existed prior to the employee’s relationship with Touch of Care.

If an employee receives a complaint or an accusation from a client, a caregiver or family member, the employee shall refer such person to the office. The Quality Assurance Coordinator will document and address all complaints and will investigate complaints as appropriate. All complaints and incidents will be reviewed to see if they meet the state-required reportable occurrences. If the elements of a reportable occurrence are met, the Agency Manager will assure that a report is made to the CDPHE within one business day of the event being known to the agency; therefore, it is every employee’s responsibility to report any complaint or concern to the agency immediately. Touch of Care will handle each situation individually.

All client complaints will be investigated by a member of our Quality Assurance Team. Investigations will involve interviewing all parties involved, reviewing any pertinent documentation, and performing on-site assessments as needed.

In serious situations, an employee may be placed on unpaid leave at the discretion of the Agency Manager pending the results of an investigation. Employees shall cooperate promptly with complaint investigations in order to relay their side of the story. This process is for the benefit of the client, the employee, and the agency as a whole.

Based on the results of such investigation and other information that may be available to Touch of Care, the employee may be disciplined up to and including termination of employment. Such action will be dependent upon the severity of and the nature of the complaint or accusation. Substantiated accusations of theft or other criminal conduct will be reported to the appropriate authorities for further investigation.

The Quality Assurance Coordinator will ensure that the complainant has been advised about the outcome of the investigation.

If a client requests that a provider be removed from his/her home, this request will be granted immediately. If an employee is removed from a client’s home due to a client request, such employee shall make no attempt to contact the client in any way, for any reason. Any necessary communication shall be done through the office.

Since IHSS clients approve Attendants prior to scheduling, any conflicts experiences should be brought to the attention of the Health Care Professional. In most cases, problem solving measures will be taken prior to removing the Attendant from the home.

If an employee obtains knowledge that a client has unsecured sums of money, jewelry or other valuables at their residence, this matter should be reported immediately to the office. Clients are advised to keep all narcotics and firearms secured during agency visits.

In the event that a client and/or responsible party alleges theft on the part of a Touch of Care employee, the general procedure for dealing with complaints and accusations will be followed. Touch of Care will encourage the client and/or responsible party to file a police report. If the client declines to file a report, Touch of Care will file a police report.

Employees should put client’s things back where they found them to prevent misplaced items. Employees should keep clients informed about where they are in the home and what they are doing in order to prevent suspicion. Employees shall promptly report any broken or damaged items to the office before the end of their shift.

Employees whose work requires operation of a motor vehicle must present and maintain a valid driver's license and proof of insurance. You must be listed as an insured driver on the policy and a copy must be submitted before your first day of employment. Updated documents must be submitted upon renewal. Employees must report all traffic citations received and all motor vehicle accidents occurring either during working hours or non-working hours within 5 days.

If an employee does not have a driver’s license, the availability of work will be limited.

Touch of Care has a long-standing record of nondiscrimination in employment and opportunity because of race, color, religion, sexual orientation, creed, national origin, ancestry, disability, sex or age.

It is the policy of Touch of Care to:

• strictly follow personnel procedures that will ensure equal opportunity for all people without regard to race, color, religion, sexual orientation, creed, national origin, sex, age, ancestry, marital status, disability, veteran or draft status.

• comply with all the relevant and applicable provisions of the Americans with Disabilities Act ("ADA"). Touch of Care will not discriminate against any qualified employee or job applicant with respect to any terms, privileges, or conditions of employment because of a person's physical or mental disability.

• make reasonable accommodations wherever necessary for all employees or applicants with disabilities, provided that the individual is otherwise qualified to safely perform the duties and assignments connected with the job and provided that any accommodations made do not require significant difficulty or expense.

• achieve understanding and acceptance of Touch of Care's policy on Equal Employment Opportunity by all employees and by the communities in which the company operates.

• thoroughly investigate instances of alleged discrimination and take corrective action if warranted.

• be continually alert to identify and correct any practices by individuals that are at variance with the intent of the Equal Employment Opportunity Policy.

At this time, Touch of Care would like to reaffirm this policy and call upon all personnel to effectively pursue the policy as stated.

Touch of Care intends to provide a work environment that is pleasant, healthful, comfortable, and free from intimidation, hostility or other offenses which might interfere with work performance. Harassment of any sort – verbal, physical, sexual – will not be tolerated.

Harassment can take many forms. It may be, but is not limited to: words, signs, jokes, pranks, intimidation, physical contact, or violence. Harassment is not necessarily sexual in nature. Sexually harassing conduct may include unwelcome sexual advances, requests for sexual favors, or any other verbal or physical contact of a sexual nature that prevents an individual from effectively performing the duties of their position or creates an intimidating, hostile or offensive working environment, or when such conduct is made a condition of employment or compensation, either implicitly or explicitly.

All Touch of Care employees, and particularly managers, have a responsibility for keeping our work environment free of harassment. Any employee who becomes aware of an incident of harassment, whether by witnessing the incident or being told of it, must report it to their immediate manager or any management representative with whom they feel comfortable. When management becomes aware that harassment might exist, it is obligated by law to take prompt and appropriate action, whether or not the victim wants the company to do so.

Any incidents of harassment must be immediately reported to a manager or other management representative. Appropriate investigation and disciplinary action will be taken. All reports will be promptly investigated with due regard for the privacy of everyone involved. Any employee found to have harassed a fellow employee or subordinate will be subject to severe disciplinary action or possible discharge. Touch of Care will also take any additional action necessary to appropriately remedy the situation. No adverse employment action will be taken for any employee making a good faith report of alleged harassment.

Touch of Care accepts no liability for harassment of one employee by another employee. The individual who makes unwelcome advances, threatens or in any way harasses another employee is personally liable for such actions and their consequences. Touch of Care will not provide legal, financial or any other assistance to an individual accused of harassment if a legal complaint is filed.

All perspective employees will be asked during orientation to confirm that they can perform the essential functions of the job, based on the job description. Employee health conditions will be evaluated at orientation and annually thereafter to determine of any reason exists to take protective measures. Touch of Care will make reasonable accommodations for applicants with disabilities based on the Americans with Disabilities Act of 1990.

Touch of Care requires notification of any prescription medications you may be taking that would alter your ability to perform job tasks or inhibit driving safety.

The use, distribution or possession of either alcohol or drugs during work hours is strictly prohibited. This includes the use of marijuana (whether medical or non-medical). In the event that Touch of Care suspects that an employee is working while under the influence of alcohol or drugs, the employee will be required to submit to a drug and alcohol test and will be suspended without pay pending the results of the test. All such tests and examinations shall be paid for by the company and positive test results are cause for immediate termination of employment.

Should an accident or injury occur during work hours, employees may be asked to submit to a drug and alcohol test to determine if these were a factor in the accident or injury.

Employees are responsible to notify Touch of Care immediately if they display signs or symptoms of any communicable illness, such as vomiting, diarrhea, fever, open wounds, jaundice, boils or acute respiratory infections. Employees shall not return to work until the above symptoms have been gone for at least 24 hours, without the use of medications to alleviate such symptoms.

A physician’s release must be received from an employee prior to their return to work following any extended sick leave, serious injury or contagious illness, a medical leave of absence, or leave related to a worker’s compensation injury.

Upon hire, Touch of Care will offer employees the Hepatitis B series. Employees who accept the vaccination series are doing so voluntarily. Therefore, Touch of Care will not compensate staff for their time to receive the vaccinations. Touch of Care will cover the cost of the vaccinations at an affordable local venue and will allow the employee time away from work to receive them, provided that the employee follows company guidelines for requesting time off.

Any employee who accepts the opportunity to have the vaccination series must complete each of three vaccinations as scheduled. If the employee misses a vaccination appointment and does not reschedule with the appropriate time frame allowed medically, he/she forfeits his/her opportunity to receive the immunization.

Touch of Care strongly encourages all staff to receive the influenza vaccination each year. However, this is a personal choice. Touch of Care will provide information and education to staff annually about the benefits and risks of the influenza vaccination and where it can be obtained. Touch of Care will allow employees time away from work to receive this vaccination, provided that the employee follows company guidelines for requesting time off.

Touch of Care strongly encourages all staff to receive the Covid-19 vaccination each year. However, this is a personal choice. Touch of Care will provide information and education to staff annually about the benefits and risks of the Covid-19 vaccination and where it can be obtained. Touch of Care will allow employees time away from work to receive this vaccination, provided that the employee follows company guidelines for requesting time off.

We select our employees through written application, personal interview and reference checks. After all available information was considered and evaluated, you were selected to become a member of our team.

This selection process helps Touch of Care to find and employ people who are concerned with their own personal success and the success of Touch of Care; people who want to do a job well and who can carry on their work with skill and ability; and people who are comfortable with Touch of Care and who can work well with our team.

Your first ninety (90) days of employment at Touch of Care are considered an Introductory Period, and during that period you will not accrue benefits described in this Manual unless otherwise required by law. This Introductory Period will be a time for getting to know your fellow employees. It is a try-out time for both you, as an employee, and Touch of Care, as an employer. During this Introductory Period, Touch of Care will evaluate your suitability for employment, and you can evaluate Touch of Care as well. At any time during this first ninety (90) days, you may resign without any detriment to your record. If, during this period, your work habits, attitude, attendance or performance do not measure up to our standards, we may release you.

Employees also serve a probationary period beginning on the date of change in job title.

At the end of the Introductory Period, your manager will discuss your job performance with you. During the course of the discussion, you are encouraged to give your comments and ideas as well.

Please understand that completion of the Introductory Period does not guarantee continued employment for any specified period of time, nor does it require that an employee be discharged only for "cause."

A former employee who has been rehired after a separation from Touch of Care of more than one (1) year is considered an introductory employee during their first ninety (90) days following rehire.

A performance evaluation will be completed for all employees after the introductory period and after each anniversary of their date of hire. Interim evaluations may be completed at any time to address either positive or negative issues. Direct care staff will be supervised in Client Homes regularly to assure quality of care being provided.

After having learned to competently perform your duties, your next step is to familiarize yourself with other Touch of Care activities. This can prove valuable to you, our clients and Touch of Care as well. Touch of Care may provide additional “cross-training.”

Knowledge of the services of Touch of Care will help you avoid the “I don't know” syndrome. Our clients' confidence in you increases as you are able to answer their basic questions. However, please don't pretend you know the answer or try to guess the answer when you are uncertain. If you are unsure of the correct information, refer the inquiry to your manager, or to a person more qualified to respond.

Touch of Care strives to provide consistency in our client’s care. We continually focus on the big picture of each agency as a whole, and we will schedule staff according to our client’s ever-changing needs, as well as our employee’s requests for time off.

Employees shall support the Scheduler and his/her decisions. If an employee is concerned about a client’s schedule, he/she should contact the Scheduler; this issue should not be discussed with the client. If a client questions the schedule, the employee shall assure the client that the agency is working in the client’s best interest and shall encourage the client to contact the office with specific scheduling issues or requests.

Employees cannot work in Medicaid client homes while other home care workers are providing similar services to a client. This is to prevent duplication of service.

Direct care staff may not work in a Medicaid client home when a C.N.A. from another agency is present as well.

Touch of Care employees are trained at orientation about the differences between skilled (medical) and unskilled (non-medical) personal care. All employees are responsible to know the differences which are explained during training.

PCPs shall not perform any skilled (medical) personal care task for any Touch of Care client. In the event that a client is in need of skilled care, the employee shall contact the office for direction. In the event that an employee is unsure whether or not a task is skilled, the employee shall contact the office for clarification before performing the task.

IHSS Attendants must adhere to each client’s Plan of Care.

If you are employed by Touch of Care in a full-time position, Touch of Care will expect that your position here is your primary employment. Any outside activity must not interfere with your ability to properly perform your job duties at Touch of Care. If you are thinking of taking on a second job, notify your manager immediately. He or she will thoroughly discuss this opportunity with you to make sure that it will not interfere with your job at Touch of Care nor pose a conflict of interest. For the safety of our staff and our clients, excessive work hours per day or per week will not be allowed.

Employees may not offer to provide private duty services for any clients that they meet through Touch of Care.

Federal regulations require that before becoming employed, all applicants must complete and sign Federal Form I-9, Employment Eligibility Verification Form; and all applicants who are hired need to present documents of identity and eligibility to work in the U. S.

Ask any of our employees who have worked with us for a long time, and they will probably tell you of the many changes and improvements that have come about in their departments since they first joined us. We believe the person doing a job is in the best position to think of ways of doing it more easily, more efficiently, and more effectively. If you think of a better way of doing your job or the job of a fellow employee, discuss it with your supervisor, who will welcome your suggestions.

Remember, there may be areas in Touch of Care’s operation that can be improved. These could be in service, communications, safety, ways to reduce costs, losses, and/or waste, or other improvements you may see a need for. Please give us the benefit of your unique experience and thoughts.

Whenever people gather together to achieve goals, some rules of conduct are needed to help everyone work together efficiently, effectively, and harmoniously. Some people have problems with "rules" and "authority figures," and past experience may have justified these thoughts and feelings; however, at Touch of Care, we hold ourselves to a high standard of quality where the rules and authority figures simply assure that quality is maintained.

By accepting employment with us, you have a responsibility to Touch of Care and to your fellow employees to adhere to certain rules of behavior and conduct. The purpose of these rules is not to restrict your rights, but rather to be certain that you understand what conduct is expected and necessary. When each person is aware that he or she can fully depend upon fellow workers to follow the rules of conduct, then our organization will be a better place to work for everyone.

Generally speaking, we expect each person to act in a mature and responsible way at all times. However, to avoid any possible confusion, some of the more obvious unacceptable activities are noted below. Your avoidance of these activities will be to your benefit as well as the benefit of Touch of Care. If you have any questions concerning any work or safety rule, or any of the unacceptable activities listed, please see your supervisor for an explanation.

Occurrences of any of the following violations, because of their seriousness, are likely to result in immediate dismissal without warning:

• Misuse of computer passwords and information obtained by accessing a

password that you do not have the authority to use.

• Violation of any company rule; any deliberate action that is extreme in nature and is obviously detrimental to Touch of Care's efforts to operate profitably.

• Violation of security or safety rules or failure to observe safety rules or Touch of Care safety practices; failure to wear required safety equipment; tampering with Touch of Care equipment or safety equipment.

• Negligence or any careless action which endangers the life or safety of another person.

• Being intoxicated or under the influence of controlled substance drugs while at work; use or possession or sale of controlled substance drugs in any quantity while on company premises or during normal work hours except medications prescribed by a physician which do not impair work performance.

• Unauthorized possession of dangerous or illegal firearms, weapons or explosives on company property or while on duty.

• Engaging in criminal conduct or acts of violence, or making threats of violence toward anyone on company premises or when representing Touch of Care; fighting, or horseplay or provoking a fight on company property, or negligent damage of property.

• Insubordination or refusing to obey instructions properly issued by your supervisor pertaining to your work; refusal to help out on a special assignment.

• Threatening, intimidating or coercing fellow employees on or off the premises — at any time, for any purpose.

• Engaging in an act of sabotage; willfully or with gross negligence causing the destruction or damage of company property, or the property of fellow employees, clients, suppliers, or visitors in any manner.

• Theft of company property or the property of fellow employees; unauthorized possession or removal of any company property, including documents, from the premises without prior permission from management; unauthorized use of company equipment or property for personal reasons; using company equipment for profit.

• Dishonesty; willful falsification or misrepresentation on your application for employment or other work records; falsifying reason for a leave of absence or other data requested by Touch of Care; alteration of company records or other company documents.

• Violating the non-disclosure agreement; giving confidential or proprietary Touch of Care information to competitors or other organizations or to unauthorized Touch of Care employees; working for a competing business while a Touch of Care employee; breach of confidentiality of personnel information.

• Malicious gossip and/or spreading rumors; engaging in behavior designed to create discord and lack of harmony; interfering with another employee on the job; willfully restricting work output.

• Immoral conduct or indecency.

• Conducting a lottery or gambling on company premises.

• Unsatisfactory or careless work; failure to meet quality standards as explained to you by your manager; mistakes due to carelessness or failure to get necessary instructions.

• Any act of harassment, sexual, racial or other; telling sexist or racial-type jokes; making racial or ethnic slurs.

• Leaving work before the end of a workday or not being ready to work at the start of a workday without approval of your supervisor; stopping work before time specified for such purposes.

• Sleeping on the job; loitering or loafing during working hours.

• Excessive use of company telephone for personal calls.

• Smoking in restricted areas or at non-designated times, as specified by company rules. Smoking in any Touch of Care building or smoking in any Touch of Care client’s home (unless you live in the client’s home, i.e., relative providers).

• Posting, removing or altering notices on any bulletin board on company property without permission of an officer of Touch of Care

• Failure to report an absence or late arrival, excessive absence or lateness.

• Obscene or abusive language toward any supervisor, employee or client; indifference or rudeness towards a client or fellow employee; any disorderly/antagonistic conduct on company premises.

• Speeding or careless driving while on Touch of Care business.

• Soliciting during working hours and/or in working areas; selling merchandise or collecting funds of any kind for charities or others without authorization during business hours, or at a time or place that interferes with the work of another employee on company premises.

• Communication with the media (newspaper, radio, television) concerning any aspect of Touch of Care operations or services, a client or employee, shall only be made by a designated representative of Touch of Care.

• Failure to maintain a neat and clean appearance in terms of the standards established by Touch of Care management; any departure from accepted conventional modes of dress or personal grooming; wearing improper or unsafe clothing.

• Failure to use Electronic Visit Verification; alteration of your own time or records or attendance documents; altering another employee's time or records or causing someone to alter your time or records.

An occurrence of any of the previously listed activities, as well as violations of any Touch of Care rules or policies, is likely to result in immediate dismissal. This list is not all-inclusive, and, notwithstanding this illustrative list, all employees remain employed “at will.”

Employment with Touch of Care is "at will" in that you can be terminated with or without cause, and with or without notice, at any time, at the option of either Touch of Care or yourself, except as otherwise provided by law.

It is Touch of Care's desire to pay wages and salaries that are competitive with other employers in the marketplace in a way that will be motivational, fair and equitable, variable with individual and company performance and in compliance with all applicable statutory requirements.

You are employed by Touch of Care and will be carried directly on our payroll. No person may be paid directly out of petty cash or any other such funds for work

performed.

It is Touch of Care’s policy not to grant pay in advance of regularly scheduled pay dates.

Deductions from pay are permissible when an exempt employee is absent from work for one or more full days for personal reasons other than sickness or disability; to offset amounts employees receive as jury or witness fees, or for military pay; or for unpaid disciplinary suspensions of one or more full days imposed in good faith for workplace conduct rule infractions. We are also not required to pay the full salary for penalties imposed in good faith for infractions of safety rules of major significance, or for weeks in which an exempt employee takes unpaid leave.

It is our policy to comply with the salary basis requirements of the FLSA. Therefore, we prohibit all company managers from making any improper deductions from the salaries of exempt employees. We want employees to be aware of this policy and that the company does not allow deductions that violate the FLSA.

Touch of Care is required by law to make certain deductions from your paycheck each time one is prepared. Among these are your federal and state income taxes and your contribution to Social Security as required by law. These deductions will be itemized on your check stub. The amount of the deductions may depend on your earnings and on the information you furnish on your W-4 form regarding the number of dependents/exemptions you claim. Any change in name, address, telephone number, marital status or number of exemptions must be reported to the office immediately, to ensure proper credit for tax purposes. The W-2 form you receive for each year indicates precisely how much of your earnings were deducted for these purposes. Any other mandatory deductions to be made from your paycheck, such as court-ordered attachments, will be explained whenever Touch of Care is ordered to make such deductions.

Pay stubs showing the calculations of pay and deductions are provided each payday. Please retain copies for your personal records.

Should you find that you need an additional copy of a pay stub, submit a written request by way of the Request for Pay Stubs and Pay Information form. Once the request is received, Touch of Care will provide the requested copies within 7 days.

Verification of Employment forms are completed in a timely manner once received by the payroll office. Only limited verbal verifications of employment including date of employment can be provided by the Agency Managers and the Executive Assistant. Further information will require a release from the employee.

Upon submitting an application for employment, each applicant consents to personal and professional reference checks as well as background checks through the Colorado Bureau of Investigation or other means, DORA and CAPS (Colorado Adult Protective Services Check).

If an applicant has not been a resident of Colorado for at least two (2) years, Touch of Care will conduct a 50-state background check. All employees are subject to random background checks throughout their employment.

Employees must notify Touch of Care within one day of any criminal charges or arrests that occur during employment.

Touch of Care will use discretion in hiring and employee retention based on the results of reference and background checks. If an applicant has any criminal offenses, the Agency Manager will review and make the final decision.

Every effort is made to avoid errors in your paycheck. If you believe an error has been made, tell the Touch of Care office immediately. Necessary steps will be taken to research the problem and to assure that a correction is made properly and promptly.

All overtime must be approved in advance by the office before it is worked. If you are scheduled for overtime, it is considered authorized. In the event that you have worked in excess of 40 hours in a week or 12 hours in a day, you will be compensated at the rate of 1 ½ times your normal hourly rate.

If you are scheduled to work a holiday, you will be compensated at the rate of 1 ½ times your normal hourly rate. Our observed holidays are:

New Year’s Day

Easter

Administrative staff will be paid for holidays if the holiday is on a regularly scheduled workday. Administrative staff will be paid for the number of hours they are regularly scheduled.

Our payroll workweek begins on Sunday and ends on Saturday.

Fiscal Pay Period/Bi-weekly:

(26 pay periods per year) Payday is on every other Monday for services performed for the two (2) week period ending two weeks previously. Pay dates will be distributed at the beginning of the year, or upon your employment for your information.

Changes will be made and announced in advance whenever Touch of Care holidays or closings interfere with the normal payday.

Paychecks can be picked up at the Touch of Care office on payday.

If you would like your check mailed or picked up by a third party, you must complete a Paycheck Release Authorization form. Checks that are mailed will be mailed from the local Touch of Care office on payday.

Some alternative Paycheck pickup locations are available for employees working in outlying areas. Checks will be available at these locations on payday. You should discuss paycheck pickup with the office.

Unfortunately, you will not be paid when work is not available due to circumstances not within Touch of Care's control; the following are examples of such circumstances.

• Operations cannot commence or continue due to threats to employees or property or when recommended by civil authorities.
• Public utilities fail to supply electricity, water, or gas, or there is a failure in the public utilities, or sewer system.

• The interruption of work is caused by an "Act of God" (inclement weather, fire, flood, earthquake, avalanche, etc.) or some other cause not within Touch of Care's control.

Touch of Care hopes and expects that you will give at least a two week notice in the event you intend to leave our employ.

Touch of Care does not pay severance pay. When you leave Touch of Care, you will be paid for actual time worked.

Plans of Care are developed with each individual client to meet their needs and to be in compliance with the applicable payor source. Employees are responsible to have a Plan of Care for each client they see and to follow it. All direct care staff shall perform tasks as assigned on the Plan of Care.

IHSS Attendants must adhere to each client’s Plan of Care. IHSS Attendants may not provide any tasks not listed on the Client-Specific Plan of Care. IHSS Attendants must split types of care appropriately based on their client’s needs and time frames allocated by Touch of Care.

Any task not listed on a client’s Plan of Care is a non-billable task. If a client requests a task that is not listed on his/her Plan of Care, the employee will contact the office for direction and document any extra task approval they receive on their timesheet. Employees are not permitted to perform tasks without assignment or permission.

Touch of Care’s direct care staff will be paid for drive time between client homes.

Touch of Care monitors drive time amounts. Drive time is actual. Excessive drive time should be explained.

Visit time is actual and results are electronically verified.

Federal and State Regulations require the utilization of Electronic Visit Verification (EVV).

Touch of Care has implemented a new web-based software, AxisCare to meet these federal and state regulations. AxisCare has a free APP available to staff.

AxisCare allows for clock-in upon arrival and departure from client homes. AxisCare also allows for recording ADLs completed and recording of any change of condition.

If an employee doesn’t want to use the App, they will be required to use Telephony.

This will allow you to clock-in and out from your patient’s home via a phone call. It is vital that phone calls are made upon arrival and departure from your client’s home, as this will account for how your hours are paid. You will also record tasks completed with telephony.

What you need to do:

Call 1-855-631-3160

Press 1 for “clock-in” option, press 2 for “clock-out” option.

Enter your Caregiver ID #. (Contact your office for your caregiver ID.)

You will be able to hear voice mails from the office at the beginning of your shift/visit and to leave messages for the office at the end of your shift/visit.

You will answer yes/no for each ADL (Activity of Daily Living) task for each client at the end of your visit.

Using EVV correctly and accurately is a requirement of your employment with Touch of Care.

We hope you will manage your financial affairs so that we will not be obligated to execute any court-ordered wage assignment or garnishment against your wages. However, whenever court-ordered deductions are to be taken from your paycheck, you will be notified.

Touch of Care’s administrative staff completes the schedule each week, with the exception of IHSS cases which may be scheduled by the client. All requests for time off and schedule changes must be turned in to the office by Monday at 2:30 p.m. for the upcoming week, with the exception of IHSS Attendants who are required to provide a 2-week notice.

Relative only provider schedules are determined initially with the agency and client; if there are any changes the relative only provider must notify the agency. Schedules are available Friday after 2:00 p.m. via AxisCare. If using Telephony, paper schedules must be picked up between 2:00 p.m. and 4:00 p.m. on Friday. Schedules must be picked up during this timeframe. If you are unable to come to the office during this time, it is your responsibility to make arrangements with the office staff.

Our Direct Care Staff must contact the office with any request to change a schedule before any change can be made. Direct Care Staff will not contact clients directly to change their schedule. If a Direct Care Staff wishes to perform a visit early or finishes a visit early, he/she must first call the office for approval. Likewise, if Direct Care Staff needs to extend a visit past the scheduled completion time because of client need, he/she must first obtain approval from the office.

IHSS Attendants must notify the client and call the agency office if schedule changes are needed. Substantial changes will be confirmed with the IHSS client before they are approved. IHSS Attendants may shorten or extend visits according to client needs. If more than 15 minutes of additional care is needed, the employee must notify the office so that visits can be adjusted by administrative staff.

Employees should never go to a client’s home unless Touch of Care has scheduled or approved them to do so. The agency will monitor to assure professional boundaries are maintained with all agency clients.

Your Client Care Coordinator is your main contact for any client-related issues or concerns. Keep in mind that anyone in the office can usually either help you or direct you.

From time to time, it may be necessary for you to be absent from work. Touch of Care is aware that emergencies, illnesses, or pressing personal business that cannot be scheduled outside your work hours may arise. If you are unable to report to work, or if you will arrive late, please contact the office immediately. Give as much time as possible to arrange for someone else to cover your position until you arrive. If you know in advance that you will need to be absent, you are required to request this time off.

When you call in to inform Touch of Care of an unexpected absence or late arrival please do so as soon as possible with a minimum of one (1) hour advance notice of a scheduled visit if you are unable to make a visit. It is expected that all employees notify the office or on-call staff member as soon as it becomes a possibility that an assignment may be missed. IHSS Attendants must notify both the client and the office and must confirm with the office that the visit can be covered. For overnight shifts, a minimum of six (6) hours advance notice must be given.

For late arrivals, please notify the office in advance of the scheduled arrival time as soon as you are aware that you will be delayed. Touch of Care tracks employee tardiness and excessive tardiness will not be tolerated.

If you are absent five (5) or more days because of illness, you will be required to provide written documentation from a doctor that you are able to resume normal work duties before you will be allowed to return to work. You will be responsible for any charges made by your doctor for this documentation.

If Touch of Care feels that an employee’s absenteeism is detrimental to a client’s care, the employee will no longer be scheduled in the client’s home. If at any time Touch of Care deems that an employee has excessive absenteeism, the employee will be put on an attendance improvement plan.

Employees are required to have reliable transportation, and accordingly, recurring car trouble is not an acceptable reason for failure to keep scheduled assignments.

If an employee finds that he/she is not needed for a visit, the employee is required to call the office before leaving the client’s home. The employee should call from the client’s home when possible. If the client does not answer the door, the employee should call the office for instructions. In this case, employees should use the nearest available phone, such as a neighbor’s phone or cell phone. Missed visits will be documented by the agency in the client’s record.

Touch of Care’s reputation as an agency of excellence is dependent upon our staff working as scheduled. Any No Call/ No Show visits will result in immediate disciplinary action, up to and including discharge. All employees are advised to read their schedules carefully each evening and each morning.

Touch of Care interviews each employee before hiring regarding work area and availability. At this time, each employee is providing their permanent availability. Any requests to change work area or availability must be put in writing and turned in to the office for consideration. Requests may or may not be granted, depending on current staffing and client needs. Agency Managers will determine if these requests will be approved. In the case of a direct care staff member who works for two programs, it will be up to the Agency Manager of the program that the staff member works for the majority of the time.

Requests for Time Off are processed every week by the Scheduler. Therefore, all requests for time off and schedule changes must be turned in to the office by Monday at 2:30 p.m. for the upcoming week, with the exception of IHSS Attendants who are required to provide 2 week notice for time off or scheduling changes. Employees who wish to take time off must complete a Request for Time Off form. Turning in the form does not guarantee that the request will be approved. Late requests will not be accepted.

Due to the scope of our business and the services that we offer, only a limited number of employees per service area will be granted time off at any given time. This includes direct care as well as administrative staff. Employees are advised not to make plans for their requested time off until the time off request has been approved. Employees are encouraged to put in their requests early.

If an emergency situation arises while an employee is working, a call can be made to the Touch of Care office, and office staff will return the call as soon as possible.

To satisfy reporting requirements, employees may report changes in client conditions by leaving a detailed message for the on-call staff member. Employees should not request call backs outside office hours for non-urgent issues. Employees should identify themselves, the client, and the agency they are with when calling in.

We expect a lot from our employees during our working hours and feel that each of us needs a break from our duties during our busy business schedule. We feel that we will all be more productive and perform our duties more safely if we take our allotted lunch period. Each employee is entitled to take a one-half hour (30 minute) lunch period when scheduled 5 hours or more.

Oftentimes, employees are unable to leave their client’s homes to take a lunch break, so their lunches are paid. If employees are able to take a break between scheduled client visits, the lunch is unpaid.

Employees will not eat client’s food. It is expected that employees will bring their own food to eat when eating in client’s homes.

Employees are entitled to two ten (10) minute paid breaks per eight (8) hour day.

Recognized Holidays

Holiday Policies

In addition to receiving an equitable salary and having an equal opportunity for professional development and advancement, you may be eligible to enjoy other benefits which will enhance your job satisfaction. We are certain that you will agree that the benefits program described in this Manual represents a very large investment by Touch of Care, and we trust that you will avoid abusing any of the program's benefits. A good benefits program is a solid investment in Touch of Care and its employees. It not only ensures the loyalty of long-time capable employees, but it also helps to attract talented newcomers who can help Touch of Care grow. Touch of Care will periodically review the benefits program and will make modifications as appropriate to the company's condition.

If you are a full-time employee, you will enjoy all of the benefits described in this manual as soon as you meet the eligibility requirements for each particular benefit.

If you are a part-time or temporary employee, you will enjoy those benefits which are required by law to be afforded to you, provided that you meet the minimum requirements set forth by law and in the benefit plan(s).

No benefits are available to you during your Introductory Period, except as otherwise provided.

All administrative employees are eligible for Holiday pay if the holiday falls on the employee’s regular scheduled workday. Touch of Care observes the following holidays:

New Year’s Day

Easter

We observe all national holidays on the day designated by common business practice. Whenever possible, Touch of Care will not schedule clients to be seen on holidays. However, some of our clients require care on holidays, so it will be possible that you will be scheduled to work these days. If an employee cannot work on a holiday, they must fill out a Request for Time Off form. Turning in this form does not guarantee that the request will be approved.

If you are scheduled or assigned to work on an observed holiday, you will be reimbursed at a rate of one and one-half (1 ½) times your normal rate of pay for hours worked that day. Administrative staff are paid for their regularly scheduled hours if an observed holiday falls on a regularly scheduled workday.

Full-time administrative staff members working an average of thirty (30) or more administrative hours per week over the course of one year will be entitled to paid vacation time after one year of employment. For every hour per week worked by an administrative employee, he/she will accrue .0386 hour of vacation time, up to a maximum accumulation of eighty (80) hours.

All Paid Time Off for full time eligible administrative employees may be taken in increments of hours, half day or full day. If you wish to use Vacation Time, administrative staff must enter this into T-sheets including dates and hours of vacation time to be used. Turning in a request for Time Off does not constitute a request for payment. Keep in mind that if you take time off, it remains your responsibility to enter request for payment into T-sheets.

Every effort will be made to grant your vacation time at the time you desire. However, vacation time cannot interfere with your program's operation and therefore must be approved by your manager at least one (1) month in advance. If any conflicts arise in requests for vacation time, preference will be given to the employee with the most seniority.

Vacation time for full-time administrative employees will be paid at their regular hourly rate.

At this time, Vacation Time must be used in the year it was earned. Vacation Time cannot be carried over to a subsequent year.

The purpose of Vacation Time is to provide you with a time to rest and relax, or to cover emergency personal situations; therefore, no additional wages or salary will be paid to you in lieu of Vacation Time.

It is your civic duty as a citizen to report for jury duty whenever called. If you are called for jury duty, we will permit you to take the necessary time off and we wish to help you avoid any financial loss because of such service. You will be paid at your normal rate for the first three (3) days. If jury service continues beyond the third day, employees will be compensated for the difference between the employee’s regular pay for scheduled hours and the jury duty pay as provided by the court, to a limit of two weeks. The employee must present the juror service certificate to Touch of Care’s Payroll Office and turn in a timesheet for all hours served on the Jury.

You must notify your supervisor within forty-eight (48) hours of receipt of the jury summons.

On any day or half-day, you are not required to serve, you will be expected to return to work. In order to receive jury duty, pay, you must present a statement of jury service and pay to your manager. This document is issued by the court.

Employees accrue 1 hour of paid leave per 30 hours worked up to 48 hours per year. You will be paid at your regular pay rate for HFWA leave. Up to 48 accrued hours of unused leave carries over for use the next year. Accrued unused hours are not payable upon termination.

A mental or physical illness, injury or health condition that prevents work.

Domestic abuse, sexual assault, or criminal harassment leading to health, relocation, legal or other service needs.

Employee has a family member with a condition described in 1 & 2 above.

In a Public Health Emergency, a public official has closed the workplace, or the school or place of care of the employee’s child.

If you take HFWA leave for 4 or more consecutive days, you must provide documentation showing that leave was for a qualifying reason.

Employees are required to let the office know that they are requesting HFWA leave payment.

Occasionally, for medical, personal, or other reasons, you may need to be temporarily released from the duties of your job with Touch of Care but may not wish to submit your resignation. Under certain circumstances, you may be eligible for an unpaid leave of absence.

There are several types of unpaid leaves which you may be eligible for.

Employees that are the victim of domestic abuse, stalking, sexual assault or other crimes related to domestic abuse are allowed up to three (3) days of unpaid leave in any twelve (12) month period. This is in accordance with the Employee Domestic Abuse Leave Law. This applies to employees who have been employed with Touch of Care for at least one year. Leave is approved to do any of the following: Seek a civil protection order; obtain medical care or mental health counseling, secure a home away from the perpetrator or seek legal assistance to address related issues.

seq level0 ) Employees are eligible if they have been actively employed for 12 months and worked at least 1250 hours (an average of 25 hours per week) during those 12 months.

1. Under the circumstances set forth below, each eligible employee shall have up to a total of 12 weeks leave during any one-year period.

1. A family leave shall be granted upon the birth or adoption of a child of the employee, or upon the serious illness of the employee's child, spouse, or parent.

1. A medical leave may be granted upon the employee's own serious illness or pregnancy.

1. Whenever possible, and subject to your health care provider's approval, absences for planned medical treatment should be scheduled so as not to unduly disrupt company operations.

1. In appropriate circumstances, we may require you to be examined by a company designated physician, at company expense.

1. In the event of a serious illness to the employee or his/her child, spouse, or parent, creating a need for unforeseeable family or medical leave, the employee should provide us with notice, as soon as practicable, of any needed time off, and a written doctor's certificate indicating the expected duration and nature of the illness, particularly as it relates to the employee's ability to come to work or the need for that employee's presence at home to care for a seriously ill family member.

1. Employees shall be required to give 30-day advance notice in the event of a foreseeable medical treatment. To assist us in arranging work assignments during your absence, we ask that you give us prior notice, to the extent possible, of an expected birth or adoption, as well as an indication, to the extent known, of your expected return date. To facilitate your return to work, we also ask that you provide us with two weeks advance notification of your intended return date. Failure to do so may delay your return date.

1. For purposes of this policy, a child is defined as a natural, adopted, or foster child, a stepchild or a legal ward. If the child is over 18, he/she must be unable to care for himself/herself due to a serious illness.

1. A parent is defined as the employee's or his/her spouse's natural, adoptive, or foster parent, stepparent, or legal guardian.

1. A serious illness is defined as a disabling physical or mental illness, injury, impairment, or condition involving (1) inpatient care in a hospital, nursing home, or hospice; or (2) outpatient care requiring continuing treatment or supervision from a health care professional.

1. Leave of absence rights available to you under other sections of our policy shall be counted towards the total time off available under this section.

1. Upon completion of a leave granted under this section, every effort will be made to reinstate you to your original position, or an equivalent one if such positions are available.

1. If, due to your own medical circumstances, you are no longer able to perform your original job, we will attempt to transfer you to alternate suitable work, if available.

1. While on a leave of absence provided for under this policy, we will continue your group health insurance benefits for up to a maximum of 12 weeks leave time during any one-year period. During the period of your leave, you will be responsible for paying the total premium for your coverage and that of your dependents. If your leave extends beyond 12 weeks, you shall be offered the opportunity to purchase continuing coverage under state and federal COBRA continuation rules.

1. Other accumulated fringe benefits such as seniority, vacation time, etc., shall be preserved at the level earned as of commencement of the leave, but shall not accrue further during any such leave period.

1. Should you require an extended leave beyond the period of time described in this policy, we will seek to return you to a suitable position but cannot guarantee that one will be available.

Employees are allowed up to six (6) hours per month (18 hours per academic year) of unpaid leave for the purposes of attending an academic activity for or with their child. This is in accordance with the Parental Involvement in K-12 Education Act.

Employees wishing to have time off to attend academic events for or with their children need to follow the regular company procedure for requesting time off, as detailed in this manual.

Voting is an important right and responsibility of all citizens. Touch of Care encourages its employees to exercise their voting rights in all municipal, state and federal elections. Under most circumstances, it is possible to vote either before or after a scheduled shift. If it is necessary for you to arrive late or leave early to vote in any election, you should make arrangements with the office no later than the day prior to Election Day.

Touch of Care may grant an unpaid leave of absence for illness, disability or pregnancy. To request a disability leave of absence from your manager, you should submit, or have someone submit for you, a statement of ill health or disability from your doctor. (Pregnancy is treated, for the purposes of this policy, the same as an illness or disability.) An approved disability leave may be granted for up to ninety (90) days. Whenever possible, you are required to give as much notice as possible of your pending need for a disability leave of absence in writing.

In the case of pregnancy, please inform your manager as soon as possible of the date you and your doctor anticipate that you will begin your leave. Your job status will be protected to the extent that we will make every effort to allow you to return to your former work, or similar work if available, for which you may be qualified. However, we cannot guarantee you that a position will be available at the time of your return.

At the time the disability leave begins, any accrued Vacation Time previously earned but not used at that time will be paid if the employee so desires. These benefits do not continue to accrue during a leave of absence. This policy applies to all employees. Your group insurance booklet should be reviewed to determine your insurance coverage during a leave of absence.

Employees who must remain away from work for more than the period of time allowed above will be considered terminated from employment. They are welcome to re-apply subject to Touch of Care's usual hiring policies.

Employees who develop an illness or physical condition which requires medical treatment or restrictions and precautions as to their health will be required to submit a physician's statement. This statement must give approval that continued full-time employment in their present position will not jeopardize their health or the safety of others, in the event they continue to work. A similar statement is required upon return from a disability leave.

Should your attendance or job performance suffer during the period preceding and/or following a disability leave, we will accommodate you to the extent provided by law. We are under no obligation to reduce or alter your workload, or to assign fewer than the usual hours of work.

If you are a full-time employee and are inducted into the U.S. Armed Forces, you will be eligible for re-employment after completing military service, provided:

1. You show your orders to your manager as soon as you receive them.
2. You satisfactorily complete your active-duty service.
3. You enter the military service directly from your employment with Touch of Care.
4. You apply for and are available for re-employment within ninety (90) days after discharge from active duty. If you are returning from up to six (6) months active duty for training, you must apply within a reasonable time (usually thirty (30) days) after discharge.

Employees who serve in U. S. military organizations or state militia groups may take the necessary time off without pay to fulfill this obligation and will retain all of their legal rights for continued employment under existing laws. These employees may apply unused earned Vacation time to the leave if they wish; however, they are not obliged to do so.

You are expected to notify your manager as soon as you are aware of the dates you will be on duty so that arrangements can be made for replacement during this absence.

In very special circumstances, Touch of Care may grant a leave for a personal reason, but never for taking employment elsewhere or going into business for yourself. You should request an unpaid personal leave of absence from your manager. A personal leave of absence must not interfere with the operations of your program or Touch of Care. Your supervisor will submit your request to the appropriate member of management for final approval.

A personal leave of absence may be granted for up to thirty (30) days. During a leave of absence, Vacation time and other benefits will no longer continue to accrue. Consult your group insurance booklet to determine your insurance coverage during a leave of absence. Failure to return from a leave at the time agreed will result in termination of employment.

While you are on any type of unpaid leave of absence from Touch of Care, you will be responsible for paying the total premiums for your coverage while on leave. Failure to do so may result in loss of coverage and possible refusal by the insurance carrier to allow your coverage to be reinstated.

Touch of Care is interested in the health and well-being of our employees. A comprehensive health insurance program is available for you after completion of your Introductory Period, Employees working an average of thirty (30) or more hours per week become eligible for coverage. At that time, you may choose to accept the insurance coverage, or not. If you choose not to accept the coverage, you will be asked to sign a waiver form.

When you choose insurance coverage, our insurance company provides a booklet describing your benefits; a copy of this will be given to you when you join the program.

Touch of Care will pay the required portion of the employee portion of the health insurance coverage with a generic drug benefit. You will be responsible for the remainder. Dependent coverage is available, but the employee is responsible for the entire premium for dependent coverage.

In the event of your termination of employment with Touch of Care or loss of eligibility to remain covered under our group health insurance program, you may have the right to continued coverage under our health insurance program for a limited period of time at your own expense under state & federal COBRA continuation rules. Consult the Payroll Office for details.

Today's many health insurance plans and options can be confusing and complicated. That is why Touch of Care has taken the time to review the coverages and plans available. We have selected the plan we feel provides the best coverage at affordable prices for our employees. Refer to the literature provided by our insurance company for details on your health coverage.

Your regular health insurance should pay most of your doctor and hospital bills. But there are usually hundreds of dollars of deductibles and co-payments left over. To help with these out-of-pocket expenses, we provide our full-time employees the opportunity to purchase a full line of supplemental AFLAC policies. These policies are paid in full by the employee.

Trailhead Clinics are based on the Western Slope of Colorado and offer an alternative to conventional medical coverage. This coverage is offered to all our employees upon hire and provides a variety of medical services as part of your membership. They include, but are not limited to: labs, pharmacy, no wait appointments, local services, private house calls, after hours access. Touch of Care pays your initial membership fee. Your portion is $20.00 per pay period with Touch of Care paying the remaining monthly fee for the employee. Dependent coverage is available with the entire fee being the responsibility of the employee. See the full details of this membership-based clinic in your employment packet.

Your insurance will terminate when the insurance policy terminates, when you fail to make an agreed contribution to premium when due, when you cease to be eligible for coverage under the terms of our group insurance program, or when you cease to be employed as a regular full-time employee eligible for the insurance. Touch of Care may, at the president’s discretion, continue to pay the premium, to keep your insurance in effect for a brief period if you cease to be eligible for reasons other than termination.

The Colorado Workers' Compensation Law is an insurance plan which is supervised by the state and one hundred percent (100%) paid for by Touch of Care. This law was designed to provide you with benefits for any injury which you may suffer in connection with your employment. Under the provisions of the law, if you are injured while at work, you are eligible to apply for Workers' Compensation.

If you're unable to work because of a job injury, Touch of Care and our Workers' Compensation Insurance carrier work together to assist in the payment of your medical expenses and pay you money to help support you until you're able to come back to work—automatically, without delay or red tape.

Every Touch of Care employee is protected by Workers' Compensation.

Any injury is covered if it's caused by your job—not just serious accidents, but even first-aid type injuries. Illnesses may also be covered, if they're related to your job. For example, common colds and flu are not covered, but if you caught tuberculosis while working at a TB hospital, that's covered. The main question is if the injury or illness is the result of the performance of your job.

Coverage begins the first minute you are on the job and continues any time you are working for Touch of Care. You don't have to work a certain length of time, and there's no need to earn any minimum amount of wages before you're protected.

Colorado law guarantees you three kinds of workers' compensation benefits:

Medical care to take care of the injury, including not only doctor bills, but also medicines, hospital costs, fees for lab tests, X-rays, crutches and so forth. There's no deductible and all costs are paid directly by our Workers' Compensation Insurance carrier. If you do receive a bill, be sure to submit it to the Accounting Office for payment through our insurance carrier.

• Rehabilitation services necessary to return to work — Sometimes this is just an extension of medical treatment (for example, physical therapy to strengthen muscles). However, if the injury keeps you from returning to your usual job, you may qualify for vocational rehabilitation and retraining, too. Again, all costs are paid directly by Touch of Care through our Workers' Compensation Insurance carrier.

• Cash payments for lost wages — The most common kind of payments, for "temporary disability," will be made for as long as the doctor says you're unable to work. Additional cash payments may be made after you're able to work if there's a permanent handicap—for example, the amputation of a finger or loss of sight. If the injury results in death, payments will be paid to surviving dependents.

All injuries, no matter how slight, must be reported within 24 hours to the Safety Coordinator to assure consideration under Workers' Compensation Insurance, should complications develop later. Just tell the Safety Coordinator what, where, when, and how the accident happened, enough information so that he or she can arrange medical treatment and necessary reports can be completed. Prompt reporting is the key. Benefits are automatic, but nothing can happen until your employer knows about the injury. Ensure your right to benefits by reporting every injury, no matter how slight. Even a cut finger can be disabling if an infection develops. Accident reports are found in the first aid kit, and employees are responsible to complete within 24 hours of the incident.

According to Colorado Statutes and Rule 8-2 of the Colorado Rules of Procedure, please be advised that Touch of Care has designated medical providers in several locations. In the event of a life or limb threatening emergency, the insured employee will be sent to the nearest emergency facility. One of the designated medical providers must provide follow-up care. You will have the option to choose a designated provider from the list provided to you by the Safety Coordinator. If an unauthorized medical provider treats an employee, the employee will be responsible for payment of that treatment. In the event of a non-emergency after-hours injury, the employee should contact the Touch of Care on call number. The on-call staff member will instruct the employee how to proceed.

Employees should check in with the Safety Coordinator within two business days of each physician’s appointment. If an employee is unable to work due to a worker’s compensation injury, the employee must check in with the Safety Coordinator every Monday prior to 4:00 p.m.

A release to return to work from a designated provider must be received following a leave related to a worker’s compensation injury.

Payments consist of two-thirds of your average weekly wage, up to a maximum amount set by the State Legislature. The amount of the payments, and when and how they'll be paid, are regulated by State law. Only the State Legislature can change the law.

Workers' Compensation payments are tax free. There are no deductions for state or federal taxes or Social Security.

If you report the injury promptly, you should receive the first compensation check within 14 days. After that you'll receive a check every two weeks until the doctor says you're able to go back to work.

Touch of Care pays a percentage of its payroll to the Unemployment Compensation Fund according to Touch of Care's employment history. If you become unemployed, you may be eligible for unemployment compensation, under certain conditions, for a limited period of time. Unemployment compensation provides temporary income for workers who have lost their jobs. To be eligible you must have earned a certain amount and be willing and able to work. You should apply for benefits through your local State Unemployment Office as soon as possible. Touch of Care pays the entire cost of this insurance.

The United States Government operates a system of contributory insurance known as Social Security. As a wage earner, you are required by law to contribute a set amount of your wages to the trust fund from which benefits are paid. As your employer, Touch of Care is required to deduct this amount from each paycheck you receive. In addition, Touch of Care matches your contribution dollar for dollar, thereby paying one-half of the cost of your Social Security benefits.

All employees are required by State and Agency regulations to have 6 topics of continuing education each year in order to remain employed by Touch of Care. Touch of Care provides education to all employees through our monthly newsletter Thoughts of Care. It is the responsibility of each employee to read and respond to each monthly newsletter.

From time to time, Touch of Care may arrange to have training programs to enable you to progress in your technical knowledge of our business and services. Periodic educational classes are provided to employees for continuing education purposes. Employees are required to attend training sessions when scheduled to do so unless a doctor’s excuse is provided, or the employee has approved time off during that time.

Communications

Conferences and Meetings

Successful working conditions and relationships depend upon successful communication. Not only do you need to stay aware of changes in procedures, policies and general information, you also need to communicate your ideas, suggestions, personal goals or problems as they affect your work.

In addition to the exchanges of information and expressions of ideas and attitudes which occur daily, make certain you are aware of and utilize all Touch of Care methods of communication, including this Employee Manual, our monthly newsletter, check stuffers, discussions with your supervisor or client care coordinator.

You will receive other information booklets, such as your insurance booklets, from time to time. You may take these booklets home so that your family can be more nformed about your job and your benefits.

On occasion, we may request that you attend a company or program sponsored meeting. Employees are required to attend meetings when scheduled to do so.

Please understand that you are expected to dress and groom yourself in accordance with accepted social and business standards, particularly if your job involves dealing with clients or visitors in person. Each manager or program head is responsible for establishing a reasonable dress code appropriate to the job you perform.

A neat, tasteful appearance contributes to the positive impression you make on our clients. You are expected to be suitably attired and groomed during working hours or when representing Touch of Care. A good clean appearance bolsters your own poise and self-confidence and greatly enhances our company image. All employees are expected to practice good personal hygiene, including following Universal Precautions and proper hand washing procedures.

Employees shall maintain fingernails at an appropriate length, short and with clean edges. Employees shall be mindful of excessive use of fragrant perfumes, colognes, and lotions.

Personal appearance should be a matter of concern for each employee. If your supervisor feels your attire is out of place, you may be asked to leave your workplace until you are properly attired. You will not be paid for the time you are off the job for this purpose.

Shoes must be worn at all times while on the job. Touch of Care recommends that employees carry an “indoor” pair of shoes with them that are only worn inside. This will protect client floors and employee safety.

You are encouraged to use the parking areas designated for our employees. Please keep in mind that the parking spaces adjacent to or in front of our building(s) are for clients and visitors only. Remember to lock your car every day and park within the specified areas.

It is Touch of Care’s policy not to grant pay in advance of regularly scheduled pay dates.

Touch of Care employees shall not make or receive non-emergency personal phone calls during work hours. This includes administrative staff. You are permitted to make limited local area calls on company telephones for emergency personal business only. Please do not abuse this privilege. Please don't use Touch of Care as a personal mailing address, and do not put personal mail in the stacks that are to be run through the postage meter.

All staff are required to follow appropriate phone etiquette during work hours. Etiquette guidelines are as follow:

Answer a client’s phone only if the client asks you to.

When answering, use a greeting, identify where the caller has called then identify yourself.

Example: Hello, Smith Residence, Tracy with Touch of Care speaking

Employees shall not have personal visitors during working hours. This includes administrative staff. Employees will not, under any circumstances, take any adult, child or pet with them into a client’s residence unless written approval is received from Management in advance.

This policy prohibits having a person who is not a Touch of Care employee wait outside a client’s home while the employee is performing his/her duties. It also prohibits having a person who is not an employee drive to a client’s home. If the employee needs a ride to work, he/she should be dropped off two to three houses down the street from the client’s home to protect client privacy. If an employee finds that they need a ride to work, they will notify their supervisor or the on-call staff member.

Safety is everybody's business. Safety is to be given primary importance in every aspect of planning and performing all Touch of Care activities. We want to protect you against injury and illness, as well as minimize the potential loss of production.

Please report all injuries (no matter how slight) to the office immediately, as well as anything that needs repair or is a safety hazard. Your manager or department head may post other safety procedures in your department or work area.

Complete an Accident Report anytime you have an accident, regardless of the severity. An Accident Report is in the First Aid Kit that you received upon hire.

All employees will be provided a copy of the General Safety Rules upon employment. The acknowledgement form will be signed after the employee has an opportunity to review these safety rules and to ask any questions they may have about the policy. The Safety Rules will periodically be reviewed to ensure that they are applicable and current.

Remember, failure to adhere to these rules will be considered a serious infraction and will be subject to disciplinary action. Depending on the severity of the violation, employees may be afforded instructive counseling and/or training to assure a clear understanding of the infraction and the proper conduct under organizational guidelines.

You are expected to work safely and to observe all safety rules. Remember that carelessly endangering yourself or others may lead to possible dismissal. Nothing in this policy will preclude management from terminating an employee for a safety violation or imposing whichever of the following disciplinary actions it deems appropriate. This is not a progressive disciplinary system.

Verbal warning with documentation.

Written warning outlining the nature of the offense and necessary corrective action with documentation in personnel file.

Termination.

Management, including supervisory personnel, shall be subject to the above disciplinary action for the following reasons:

Repeated safety rule violations by employees under their supervision.

Failure to provide adequate training prior to job assignment.

Failure to report accidents and provide medical attention to employees injured on the job.

Failure to take action to minimize unsafe conditions or work practices once they have been reported.

All employees have a duty to report abuse or exploitation of clients and residents of long-term care facilities, hospitals, home health agencies, hospice agencies and personal care agencies. The law establishes criminal penalties for abuse and exploitation and for failure to report these things. The law also prohibits retaliation against individuals who make such reports in good faith.

Employees should communicate any concerns about a client of Touch of Care directly to the Client Care Coordinator or another administrative staff member so that proper procedures can be followed for notifying protective services. Such reports should be made within 24 hours of the time an employee suspects possible abuse or neglect in order to comply with Touch of Care’s reporting requirements. Employees will be in-serviced upon hire and annually regarding this policy.

Maintaining the security of Touch of Care buildings is every employee's responsibility. Develop habits that ensure security as a matter of course. For example:

• Know the location of all alarms and fire extinguishers and familiarize yourself with the proper procedure for using them, should the need arise.
• When you leave Touch of Care's premises make sure that all entrances are properly locked and secured.

Touch of Care recognizes the right of our employees to engage in political activity and encourages all employees to be good citizens. However, employees may not engage in any political activity during working hours.

When Touch of Care’s employees are at work, they should be working. Some clients are able to direct employee tasks, but others are not. Employees shall take initiative to follow the Plan of Care and perform the tasks listed with or without direction.

The following are prohibited on any Medicaid payor case:

Watching Television

Staying at a client’s home when assigned tasks are completed. *

Any other non-productive activity

*Protective Oversight

One exception to this policy is the Protective Oversight client. This type of client cannot be left alone, so employees shall not leave before the scheduled visit end time, or until someone arrives to relieve them of their supervision duties. Employees will check with the office before leaving a protective oversight visit to assure that the person there has been approved by the client’s responsible party to provide oversight for the client.

While caring for Protective Oversight clients, employees shall do their best to keep busy and to assure that the client’s home is clean and in order. A Protective Oversight client should always be kept in the line of sight of the employee unless the Plan of Care dictates otherwise.

Touch of Care discourages its employees from smoking. Smoking is regarded as a poor health habit which can detract from performance and is often offensive to co-workers and clients. Smoking is allowed only in designated areas outside the building during business hours.

The use of tobacco products of any kind is strictly prohibited in client homes. Employees who smoke may do so outside their client’s home during breaks. You can only do this if your client does not require constant line of sight supervision. You must be at least 10 feet away from client’s home. You need to make sure that the client is okay with you smoking outside their home. Properly dispose of cigarette butts. Employees are entitled to take two ten (10) minute breaks per eight-hour shift in addition to their thirty (30) minute lunch break. You are not to leave a client’s property during your breaks.

Today’s technology requires that certain employees have access to the Internet in order to conduct daily business. Very incidental personal usage of the internet will be tolerated. Browsing the Internet or accessing Porn sites is strictly forbidden. Failure to follow this policy is grounds for immediate dismissal.

Office staff will have access to Touch of Care computers and other electronics equipment for use in the course of their jobs. All office staff must log into their email accounts and job-based instant messaging applications at the start of each workday. Office staff must check email at least hourly when they are in the office. Employee email may not be set up on personal devices without approval from the IT Manager. Accordingly, employees are prohibited from forwarding Touch of Care email messages to their personal email accounts.

For privacy purposes, all employees working in the front office must lock their computers whenever they leave their desk. Internet usage is limited to work-related activities, and no employee shall download any software unless written approval is received from Management in Advance.

All email accounts are maintained on Touch of Care’s email systems and are the property of Touch of Care. Touch of Care has the right to read and keep a record of any email that users transmit via Touch of Care’s email system.

Although Touch of Care’s email system is meant for business use, Touch of Care allows the use of email for personal use subject to the following guidelines. Personal use of email should not interfere with work. The forwarding of chain letters, junk mail, jokes and executables is strictly prohibited.

Email messages created and transmitted via Touch of Care’s email system, are the property of Touch of Care. Touch of Care reserves the right to monitor all email messages transmitted via Touch of Care’s email system. Employees have no reasonable expectation of privacy when it comes to business and personal use of Touch of Care’s email system.

Email is a business communication tool, and the users are obliged to use this tool in a responsible manner. Although, by its nature, email seems to be less formal that other written communications, similar laws apply. Therefore, it is important that users are aware of the following legal risks of email. Both the user and Touch of Care can be liable for:

Sending email with libelous, defamatory, offensive, racist or obscene remarks.

Forwarding email with any libelous, defamatory, offensive, racist or obscene remarks.

Unlawfully forwarding confidential information to others.

Sending an attachment that contains a virus.

The above list does not enumerate all the legal risks involved. However, by following the guidelines provided in this policy, the user can minimize the legal risks involved in the use of email. If any user disregards the rules set out in this policy, Touch of Care can take corrective action up to and including termination of employment.

All email messages sent using Touch of Care equipment should be professional and appropriate. Write well-structured email messages and use short, descriptive subjects. Touch of Care’s email style is informal. This means that sentences can be short and to the point. However, the use of Internet abbreviations and characters such as smileys is discouraged. Signatures must include your name, job title and company name. A disclaimer will be added underneath your signature (see Disclaimer). Use a spell checker before you send an email. Do not write in capitals. If you forward email, state what action you would like the recipient to take.

Email messages that require a reply should be answered at the earliest possible time.

Email passwords should not be given to others and should be changed periodically. Email messages should not be deleted, they should be archived.

Email messages are written business records and are subject to Touch of Care’s rules and policies relating to retaining and deleting business records.

Avoid sending confidential information by email. Unless authorized to do so, the users are prohibited from using email to transmit confidential information to outside parties. Users may not access, send, receive, solicit, print, copy, or reply to confidential or proprietary information about Touch of Care, its employees, clients and other business associates. Confidential information includes but is not limited to:

Client Lists

Credit card numbers

The following disclaimer shall be added to each outgoing email:

TOC, Inc, dba Touch of Care, 2001-2020 All Rights Reserved – This message is intended only for the named recipient and may contain confidential or privileged information. It is protected by the Electronic Communications Act, 18 USC sections 2510-21 and is legally privileged. If you are not the named recipient, please delete the message and contact the sender at 1-866-874-6118 or by reply email, indicating that you received it in error.

The following acts shall constitute unacceptable usage of the technology system of Touch of Care:

Use of Touch of Care communication’s systems for personal business or to send chain letters. Use of Touch of Care’s communications systems for personal business or to send chain letters.

Forwarding of Touch of Care’s messages to external locations.

Distributing, disseminating or storing images, text or materials that might be considered indecent, pornographic, obscene or illegal.

Distributing, disseminating or storing images, text or materials that might be considered discriminatory, offensive or abusive, in context is a personal attack, sexist, racist or might be considered harassment.

Accessing copyright information in a way that violates the copyright.

Breaking into Touch of Care’s or other organizations systems or unauthorized use of a password or mailbox.

Broadcasting unsolicited personal views on social, political, religious or other non-business-related matters.

Transmitting unsolicited commercial or advertising material. Undertaking deliberate activities that waste staff effort or network resources.

Introducing any form of computer virus or malware into the Touch of Care network.

If an employee is found to have violated any of the email and internet policy rules, Touch of Care will take disciplinary action up to and including termination of employment. The actual penalty applied will be dependent on factors such as the seriousness of the breach, the employee’s disciplinary records, and any other factors deemed necessary to consider.

Should an employee witness policy abuse, they are required to report the incident immediately to Tyler Martinez by phone at 970-249-6080 or by email at HYPERLINK "mailto:tyler@touchofcarepcp.com" tyler@touchofcarepcp.com.

Touch of Care is not responsible for lost or stolen articles. Employees are discouraged from bringing items of personal property to their assignments or to the Touch of Care office. If it is necessary for an employee to have personal items with them, it is their responsibility to see that they are stored in a secure place.

Under normal circumstances, Touch of Care endorses a policy of progressive discipline in which it attempts to provide employees with notice of deficiencies and a plan for improvement. The normal disciplinary procedure that Touch of Care will follow is as follows:

Step 1: Verbal Warning

Step 2: Written Warning

However, Touch of Care retains the right to bypass the disciplinary procedures listed here and administer discipline in any manner it deems appropriate including immediate termination. This policy does not modify the “At Will” employment status of employment at Touch of Care.

These general safety rules are designed to provide you with knowledge of the recognized and established safe practices and procedures that apply to many of the work situations you may encounter while employed at this organization. It would be impossible to cover every work situation. If you are in doubt about the safety of any condition, practice or procedure, consult your supervisor for guidance.

I,__________________________________________________have read and understand the safety rules of Touch of Care. I agree to act in accordance with the safety rules at all times while working and understand that the violation of any rule is cause for stern disciplinary action which could include termination of employment.

__________________________________________________________________________

Employee Signature Date

__________________________________________________________________________

Management Signature Date

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