87 Washington Street, Rensselaer, New York, 12144, T : 518-449-1142

PCA/HHA Annual Competency Assessment – Skills Checklist    (1hr inservice)

Employee's Name:    Patient Initials:   Aides Title:

Skills Validation

Competency:  S – Satisfactory   U – Unsatisfactory       Method of evaluation:   DO – Direct Observation      VR – Verbal Response       WE – Written Exam               OT - Other

  Competency Method of Evaluation Initials
Handwashing/Universal Precautions
Proper body mechanics  
Tub or shower bath  
Bed bath / Sponge bath  
Shampoo / Hair Care  
Nail care / Oral care  
Shaving the Client  
Meal prep – simple diets  
Assist with grooming / Dressing  
Helping the client walk – ambulation/walker/cane  
Making an unoccupied / occupied bed  
Use of a bedpan/ urinal  
Peri care with catheter / emptying or cleaning  catheter bag  
Transfer client to sitting position, assist to sit at side of bed, assist to stand  
Transfer to/from  wheelchair / chair / commode  
Wheelchair safety  
Measuring intake / urine output  
Assisting with changing a clean dressing  
Care of infant/children  
Hoyer lift use / sliding board  
Assist with medications for self-directing clients (6 rights)  
Assist with Active Range of Motion (AROM) - coaching, reading, counting and supporting joints as requested  
Assist with obtaining and recording the client's weight  
Skin care positioning with the client in the bed and/or chair  
Review and observe the clients home safety and healthy environment  
Toileting or incontinence care - bedpan/urinal/incontinence brief/commode  
                                                      HHA ONLY
Temperature O/R/A
Prescribed exercises /PROM  
Special skin Care  
Assist with dressing change  
Assist with ostomy care  
Complex modified diets  
Oxygen management  


Is wearing a Face mask?  


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