Alert

Can't Clock In

You are not within the allowed time to clock in to this shift. Please try again closer to the time of the shift.

Alert

Location Error

Your device is not reporting it's location. Please make sure location services are enabled in your device settings and try again, or call your agency for instructions.

Alert

Location Error

There is no location data available for the Client's residence. Please call your agency for instructions.

Alert

Location Error

You are not close enough to the Client's residence to clock in/out. Please move closer and try again, or call your agency for instructions.

Alert

Geolocation Notification

Please enable Geolocation in the settings of your browser and allow site to use location when prompted.

Early Clock-In Alert

Please do not begin working with this client earlier than 60 minutes before your shift is scheduled to start.

Please provide an explanation as to why this task was not completed.

Cancel Submit Explanation

WorkSafe

Did you have a safe shift today?

Yes No

WorkSafe

Please explain why you did not have a safe shift today:

Done

WorkSafe

Were you injured during your shift today?

Yes No

WorkSafe

Please explain what happened during your shift to cause an injury:

Done

WorkSafe

Your company has been notified of your injury. If it is life-threatening, please hang up and dial 911. Otherwise, please call 855-365-7279 when you have left your client's home to speak with a nurse. You have also been sent this information.

Continue

WorkSafe

Your company has ben alerted of your injury. Please call them to discuss next steps once you have left your client's home.

Continue

Record Mileage

How many miles did you drive for this shift?

Record Mileage No Mileage Cancel

Change in Condition

Does the client seem different than usual? Has there been a change in mobility, eating or drinking, toileting, skin condition, or increase in swelling?

Yes No Cancel

Change in Condition

Have you reported this change in condition already today?

Yes No

Change in Condition

Thank you, you do not need to report this change again today.

Continue

Change in Condition

Does the client seem different than usual?

Yes No

Change in Condition

Does the client show reduced talking or alertness?

Yes No

Change in Condition

Is the client newly agitated, confused, or sleepy?

Yes No

Change in Condition

Does the client show any signs of pain?

Yes No

Change in Condition

Has there been a change in mobility?

Yes No

Change in Condition

Has there been a change in ability to stand and walk?

Yes No

Change in Condition

Has there been an observed or unobserved fall or slip?

Yes No

Change in Condition

Has there been a change in eating or drinking?

Yes No

Change in Condition

Has there been a change in chewing, swallowing, or breathing?

Yes No

Change in Condition

Has there been a change in toileting?

Yes No

Change in Condition

Has there been any discomfort, smell, or change in frequency associated with urination?

Yes No

Change in Condition

Has the client had diarrhea or constipation?

Yes No

Change in Condition

Have there been any new skin rashes or wounds?

Yes No

Change in Condition

Thank you for your report. Click Continue to continue clocking out or click Cancel to start over.

Continue Cancel