Client Service Delivery Form – Personal Support

Ingrese el nombre del cliente
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Ingrese la fecha del servicio
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Ingrese el nombre de CNA
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Hora en (Seleccionar)
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Tiempo de espera (seleccionar)
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Coloque una marca junto a todas las tareas que se completaron.

Tareas de cuidado personal

Baño (bañera / ducha / cama)
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Cuidado de la boca / dentaduras postizas
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Arreglar / lavar el cabello con champú / limar las uñas
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Ayudar a vestirse
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Ayudar con ir al baño / eliminación
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BM
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TAREAS MEDICAMENTE RELACIONADAS

Observar / informar cambios en la condición del cliente
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Acompañar al cliente en las citas médicas.
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Recordar al cliente que tome medicamentos
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Gire al cliente cada 2 horas
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TAREAS DE MANTENIMIENTO

Aspirar / barrer
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Quitar el polvo / trapear
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Lavandería / cambio de ropa de cama
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Otro
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AMBULATION /TRANSFER

Ayudar con transferencias / caminar
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Fomentar con una simple actividad física
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Otro
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GESTIÓN DEL HOGAR

Compras de comestibles
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Ayudar con el pago de facturas
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Otro
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NUTRICIÓN APROPIADA

Preparar comidas / limpiar
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Fomentar una nutrición adecuada / comida del servidor, líquidos
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Ayudar a comer / ofrecer bocadillos
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Notes
Por favor, deje una nota aquí ...
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Firma del cliente
Firma de clientes de entrada
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Firma del administrador
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Submit
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