Hiring Employees – procedures
and forms
New Hire Checklist (Word,
984k)
Pre-offer forms
Application (Word, 284k)
References worksheet (Word,
268k)
CORI Authorization form (Word,
264k)
Employment Eligibility forms (PDF, 380k)
Information for Potential Home Providers (Word, 64k)
Questionnaire for New
Providers (Word, 280k)
Summary
of Prospective Shared Living Home (Word, 32k)
Home Safety Checklist (Word,
48k)
Making the offer forms
Offer letter (full time) (Word,
468k)
Tax forms (PDF, 164k)
Direct deposit request (Word,
32k)
Change form (Word, 300k)
Orientation and forms to review with new hires
Benefits Summary (full time) (Word,
292k)
Employee Handbook (Word,
846k)
Timecards (Excel, 32k)
Vacation request (Word, 260k)
Check request (Word, 248k)
Petty cash (Word, 276k)
Mileage (Excel, 1.9 Mb)
Purchase order (Word, 404k)
Shared Living Guidelines (Word,
1 Mb)
Part time employees
When hiring a part time employee, all of the same forms
and strategies as hiring a full-time employee apply, except for the following:
- Use
the part-time employee offer letter template
- They receive the part-time
employee Personnel policies rather than the full-time policies
- They
do not receive the benefits summary or any related forms such as vacation request
Offer letter (part
time) (Word, 468k)
Personnel
Policies (Word,
828k)
Hiring and paying a consultant
Procedures for hiring and
paying a consultant (Word, 972k)
Consultant vs. employee checklist (Word,
268k)
Statement of Work form (Word, 976k)
Consultant registrar (Word, 276k)
Legal consultant agreement (Word, 40k)
Job descriptions
Care Manager (Word, 48k)
Program Director (Word, 48k)
Community Support Specialist (Word,
36k)
Director of Training and Development (Word,
40k)
Director of Finance and Administration (Word,
40k)
External Trainer & Consultant (Word,
36k)
Office Manager (Word, 36k)
Registered Nurse (Word, 36k)
ADULT FAMILY CARE
ADL / IADL
Flowsheet (Excel, 28k)
Agreement to provide service (Word,
1 Mb)
Assessment to stay alone (Word,
1 Mb)
Authorization to disclose
health information (Word,
1 Mb)
Caregiver evaluation form (Word,
224k)
Caregiver log (Excel,
36k)
Emergency contact sheet (Word,
1 Mb)
Incident report (Word,
40k)
Intake form (Word,
1 Mb)
Minimum Data Set - Home
Care (MDS-HC) (PDF,
112k)
Meal plan (Word,
164k)
Medication list (Word,
1 Mb)
Monthly Expenditure Report (Word,
12k)
Care Manager Monthly Check
List (Word, 12k)
Monthly AFC report (PDF,
12k)
Adult Foster Care
Semi-Annual Report (Excel,
48k)
Adult Foster Care Monthly
Level 2 Report (Excel,
48k)
Nurse Visit Note (Excel,
16k)
Verification of OIG Screening (Word,
1 Mb)
Orientation overview (Word,
1 Mb)
Physician Summary Form (PDF,
24k)
Physician Review Form (Word,
1 Mb)
Request for Services (PDF,
92k)
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Performance management
Overview (Word,
1 Mb)
Performance review form (general) (Word, 972k)
Support staff review form (Word, 108k)
Performance feedback form (Word, 968k)
Termination checklist (PDF, 659k)
Shared Living forms
Assessment to stay alone (PDF, 92k)
DMR change form (PDF, 128k)
DMR Incident Report (PDF, 68k)
Doctor list (PDF, 52k)
Emergency Evacuation Safety Plan (PDF,
164k)
Emergency fact sheet (PDF, 28k)
Financial Assessment and Agreement (PDF,
76k)
Goal form (PDF, 28k)
Healthcare checklist (PDF, 64k)
Annual ISP health and dental assessments (PDF,
72k)
Health and Dental Summary Tool (PDF,
28k)
Identification sheet (PDF, 40k)
Monthly Rec (PDF, 64k)
Check off List for Notebook (PDF, 28k)
Quarterly report (PDF, 88k)
Reviewed Policies and Procedures (PDF,
24k)
Safety Tool Assessment (PDF, 28k)
Sexual Awareness form (PDF, 60k)
Shared management of funds assessment (PDF,
36k)
Monthly Shared Living Visit Information (Word,
976k)
Evaluations
Shared Living
Annual Household Review (Word, 228k)
Cover letter: Guardian (Word,
284k)
Cover letter: Provider (Word,
240k)
Guardian
Satisfaction Survey (Word,
1 Mb)
Interviewer’s Comments & Assessment (Word,
32k)
Feedback for shared living households (Word,
972k)
Protocols and Timelines for
Evaluations: 2011 (Word, 32k)
Shared Living Home Provider
Satisfaction Survey (Word, 220k)
Satisfaction Survey
For People Supported in Shared Living (Word, 32k)
Training
An Overview of Social Role Valorization (PDF,
140k)
Person Centered Planning (PDF,
36k)
Massachusetts Community
Gateway
Metro Region Training and Development
Catalogue - Winter 2012 (Word, 1 Mb)
OTHER Polus forms
Media Consent and Release (PDF,
100k)
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