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Items required simultaneously to the execution of the Arrow Home Care LLC Direct Service Workers Agreement:

1. Hepatitis B Vaccination Notice
2. CPR Certification – ONLINE COURSES are not acceptable
3. First Aid Certification – ONLINE COURSES are not acceptable
4. Tuberculosis FREE test results
5. Level 1 Fingerprint Clearance Card
6. Article 9 and DD Training (for DDD services ONLY)
7. CPS background check
8. Criminal History Self-Disclosure (must be notarized)
9. APS background check
10. Confidentiality and HIPAA Compliance

Character reference from 3 independent parties (1 from prior employer)

Arizona Direct Care Worker Competencies Training Certification:

1. Knowledge and Skills, Fundamentals of Direct Care and Support (level 1)
2. Knowledge and Skills, Aging and Physical Disabilities (level 2)
3. Knowledge and Skills, Developmental Disabilities (level 2)

Items required to be updated Annually:

1. Proof of successfully completing at least six (6) hours of CEU's or other amount required by law.

By signing below, DCW acknowledges the information contained herein.

For the Safety, Health, and Well-Being of an Arrow Home Care Member, Caregiver acknowledges that He/She will IMMEDIATELY notify a member of Management if:

1. Arrow Home Care Client is unavailable to receive services or refuses services.
2. Arrow Home Care Client visits the ER, URGENT CARE and/or is admitted in the HOSPITAL.
3. The Caregiver is to report a DECLINE in the client's health.
4. The Caregiver has concerns about the SAFETY or LIVING conditions.
5. The Caregiver observes ABUSE or SIGNS of ABUSE to the member.

Caregiver acknowledges and agrees that He/She will not:

1. Attempt to transfer an Arrow Home Care Client (manually or using a Hoyer Lift, Gait Belt or other devices) unless said Caregiver has or has had proper training to do so.
2. Administer or set-up Medications.
3. Communicate with any third party (including but not limited to personal visits, phone calls, texts, emails or internet) while providing services unless it relates to the Arrow Home Care Client's services or is an EMERGENCY.
4. Demand or accept payment, tips or gratuities from the client for any services provided. Caregiver understands that the Arrow Home Care Client is not responsible for any service fees.
5. Accept gifts in ANY form from Arrow Home Care Client.
6. Transport an Arrow Home Care Client unless it is in the client's own personal vehicle and a letter has been given to Arrow Home Care office verifying.
7. Report hours that are not authorized by insurance provider or Arrow Home Care LLC. Hours that CANNOT be collected are but not limited to: Hospital visits, client being placed in an assisted living facility (respite hours or permanently) or similar facility and vacations.

By signing below, Caregiver acknowledges the information contained herein.

The provision of Home and Community Based Services may expose Caregivers to blood and bodily fluids which increase the risk of contracting Hepatitis B and other blood-borne infections and diseases.

Because of this, it is recommended that the caregiver obtains a Hep B vaccination series or other immunizations to protect against blood-borne infections and diseases. Although vaccination is OPTIONAL, Caregiver is required to confirm awareness of these risks.

Confirmation of Risk:

1. I understand that I am at risk of exposure to blood or bodily fluids.
2. I understand that I am at risk of contracting a blood-borne infection or disease.
3. I will follow standard safety procedures related to blood and bodily fluids.
4. I understand that it is recommended that I be immunized against Hep B and other blood-borne infections and diseases.
5. I agree that Arrow Home Care LLC Client is not liable if I contract a blood-borne infection or disease.

By signing below, Caregiver acknowledges the information contained herein.

Arrow Home Care LLC · 18631 N 19th Ave, Suite 606, Phoenix, AZ 85027

I have read and understand the Arrow Home Care LLC Handbook.