Florida Home Health Compliance Checklist

Agency Information

Field	Value
Agency Name	________________
Caregiver Name	________________
Position	HHA / CNA / RN / LPN / PT / PTA / OT / COTA / ST
Hire Date	________________
Reviewed By	________________
Review Date	________________

Identity & Employment

Requirement	Completed	Expiration
Employment Application	☐	N/A
Resume	☐	N/A
Government Photo ID	☐	____
Social Security Card	☐	N/A
Employment Authorization (I-9)	☐	If applicable
W-4	☐	N/A
Direct Deposit Form	☐	N/A
Emergency Contact Information	☐	N/A

Licenses & Certifications

Requirement	Completed	Expiration
CNA License	☐	____
HHA Certificate	☐	____
RN/LPN License	☐	____
CPR/BLS Certification	☐	____
Physical Examination	☐	____
TB Test / Quantiferon	☐	____
Driver License	☐	____
Auto Insurance	☐	____

Background Screening

Requirement	Completed
Level 2 Background Screening	☐
OIG Exclusion Check	☐
SAM Exclusion Check	☐
License Verification	☐
Reference Checks	☐

Required Training

Training	Completed	Date
HIPAA	☐	____
OSHA	☐	____
Infection Control	☐	____
Abuse, Neglect & Exploitation	☐	____
Patient Rights	☐	____
Emergency Preparedness	☐	____
Bloodborne Pathogens	☐	____
Corporate Compliance	☐	____
Fire Safety	☐	____
Fraud, Waste & Abuse	☐	____

Skills & Competency

Requirement	Completed
Orientation Completed	☐
Skills Checklist	☐
Competency Evaluation	☐
Annual Competency	☐
Job Description Signed	☐

HR Documents

Requirement	Completed
Employee Handbook Acknowledgment	☐
Confidentiality Agreement	☐
HIPAA Acknowledgment	☐
Code of Conduct	☐
Attendance Policy	☐
Dress Code Policy	☐
Cell Phone Policy	☐
Social Media Policy	☐

Health Requirements

Requirement	Completed	Expiration
Influenza Vaccine / Declination	☐	____
COVID Policy Documentation	☐	____
Hepatitis B Vaccine / Declination	☐	____

Agency Forms

Requirement	Completed
Consent Forms	☐
Patient Confidentiality	☐
Incident Reporting Policy	☐
Infection Prevention Policy	☐
Agency Orientation	☐

Final Compliance Verification

Requirement	Status
All required documents completed	☐
No expired licenses	☐
No expired certifications	☐
Required signatures completed	☐
Required training completed	☐
Background screening completed	☐
Employee meets agency requirements	☐

About HiCareGiver

HiCareGiver centralizes caregiver documents, automates expiration tracking, standardizes onboarding, manages electronic forms and signatures, monitors readiness to work, and helps agencies maintain compliance from one secure platform.