Personal Care Assistant Skills Check List

Personal Care Assistant Skills Check List


Check skills beings demonstrated. Initial and dat when each skill in evaluated. Mark met or not met. Initial,sing and date at bottom of form.

Demonstration of Skills

Date Met Not Met Re-test date Met Not Met Comments
Mobility
* Ambulations:




* ROM: Uper and Lowers




* Positioning


personal Care
* Oral:



* Bed Bath:
Date Met Not Met Re-test date Met Not Met Comments

Environmental Services

* Linen Change:Bed Occupied With Patient Bed Unoccupied

* Universal: Precautions,as written by the Agency, are used and followed

* Medication assistance Competent Client

* Mentally Incompetent

Date Met Not Met Re-test date Met Not Met Comments

Other Individual Agency Requirements

Use of special equipment