ABOUT THE AGENCY
Can your agency provide all of my care needs?
If No, will your agency help coordinate or help find the additional
services or products I need?
Is there an additional charge to help coordinate or help find those
services or products?
Is the agency: Licensed, Bonded & Insured?
Does your agency carry malpractice insurance?
Is the owner of the agency local?
____ ____ ___ How long has the agency been in business in my community?
Is the agency JCHAO (Joint Commission on Accreditation of
Healthcare Organizations) accredited?
Is the agency a member of any professional organizations?
Does the agency get inspected by an outside organization?
May I see the inspection results?
Am I able to reach someone from your agency at all hours?
Does your agency have a client list of references I can call?
Does my caregiver get evaluated on the care I receive?
Have the agency’s caregivers passed criminal background checks
& drug screening?
Have personal references been secured on all caregivers?
How is my caregiver supervised?
Am I able to talk to my caregiver’s supervisor if needed?
Will I always have the same caregiver?
Has my caregiver been trained in giving the care I need?
Do your caregivers receive continuing education & training?
Will I be able to choose my caregiver?
Can I request an alternative caregiver if I am unhappy?
Does your agency provide full-time “Live In” caregivers?
And if Yes, is there a discounted rate for care services?
ABOUT THE CAREGIVER
Is the caregiver an agency employee or an independent
contractor with a registry?
Are the caregiver’s: Licensed, Bonded & Insured?
Does the caregiver have workers’ compensation coverage?
Does the agency do a background screening on caregivers?
Are caregiver’s driving record and driver’s license checked?
Will my caregiver speak my language?
____ ____ ___ How many years of experience does my caregiver have in the kind
of care I will be receiving?
Will my caregiver be fully informed of my care needs and
ABOUT THE CARE
Will your agency design a care plan for me?
Is my care plan put into writing?
Does the agency consult my family when designing my care plan?
Does the agency consult my doctor when designing my care plan?