PCA/HHA Initial Competency Assessment – Skills Checklist

Employee's Name:   Aides Title: 

   
Date of Orientation: 

Skills Validation

Competency:  S – Satisfactory   U – Unsatisfactory       Method of evaluation:   DD – Demonstration  IS - In Service

R# Discipline Required Skill Method of Evaluation Required Competency Initials
01 PCA/HHA Handwashing*/UnivPrec  Demonstration
02 PCA/HHA  Making Occupied Bed*  Demonstration  
03 PCA/HHA  Positioning on Side*Positioning on Back*  Demonstration  
04 PCA/HHA  Bed Bath*/Sponge Bath Demonstration  
05 PCA/HHA  Nail Care/Oral Care*  Demonstration  
06 PCA/HHA   Tub Bath/Shower*  Demonstration  
07 PCA/HHA  Assist with Medications* (5 rights)  Demonstration  
08 PCA/HHA  Hoyer Lift Use Demonstration  
09 PCA/HHA  Transfer of Client to sitting* Assist to sit at side of bed* Assist   to stand* Demonstration  
10 PCA/HHA  Ambulation*/Walker/Cane Demonstration  
11 PCA/HHA  Bedpan*/Urinal Placement Demonstration  
12 PCA/HHA  Incontinence/Diaper change* Demonstration  
13 PCA/HHA  Shampoo/Hair Care  In Service  
14 PCA/HHA  Body mechanics/lifting  In Service  
15 PCA/HHA  Making Unoccupied Bed  In Service  
16 PCA/HHA  Shaving Client  In Service  
17 PCA/HHA  Skin Care Positioning In Service  
18 PCA/HHA  Grooming/Dressing In Service  
19 PCA/HHA  Meal Prep - Simple Diets  In Service  
20 PCA/HHA  Care of Infant/Children  In Service  
21 PCA/HHA  Wheelchair Safety  In Service  
22 PCA/HHA  Peri Care with Catheter  In Service  
23 PCA/HHA  Emptying Catheter Bag  In Service  
24 PCA/HHA  Measuring Urine Output In Service  
25 PCA/HHA  Prescribed Medical Equipment,   Oxygen Use, In Service  
26 HHA  Temperature: O*/R/A  Demonstration
27 HHA Pulse* Demonstration  
28 HHA Respirations*  Demonstration  
29 HHA Blood Pressure*  Demonstration  
30 HHA Prescribed Exercises/PROM* Demonstration  
31 HHA Urine Testing/Catheter Care  In Service  
32 HHA Intake/Output  In Service  
33 HHA Complex Modified Diets  In Service  
34 HHA Special Skin Care  In Service  
35 HHA Assist with Dressing Change In Service  
36 HHA Assist Ostomy Care  In Service  
 
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