Welcome to Silver Home Care

Direct Care Worker Orientation

The people you'll care for used to do these things themselves. Now they can't. Some are scared. Some are grieving. Some are angry about needing help at all. You're walking into that.

As a Direct Care Worker, your actions directly affect the well-being of the people we serve. You can make a client feel safer, more comfortable, and more like themselves. You can also cause harm—through neglect, impatience, inconsistency, or treating the work like a checklist instead of a relationship.

This orientation is your introduction to who we are, what you can expect from us, and what we expect from you.

Video Training

Watch essential orientation videos covering key topics and policies

Written Guide

Comprehensive handbook covering all policies, procedures, and expectations

Required Videos

Orientation Video Training

Watch these essential videos before your first shift. Each covers critical policies and expectations.

3 min

Our Mission

Understanding Silver Home Care's mission and the importance of person-centered care

Available
2 min

Punctuality & Attendance

Why showing up on time matters and how to handle schedule changes

Available
4 min

Client Abandonment

What abandonment means, why it's serious, and how to prevent it

Available
2 min

Dress Code & Hygiene

Professional appearance standards and personal hygiene requirements

Available
3 min

TB Testing & Health Screening

Tuberculosis testing requirements and annual health screening procedures

Available
Written Orientation Guide

Complete Training Handbook

Read through all eight parts carefully. This handbook covers everything you need to know before your first shift.

Part I: Who We Are & What We Do

Our Mission

To improve lives, one visit at a time.

In home care, improvement doesn't look like a big dramatic change. It looks like something quieter: a day that feels more manageable. A routine that holds. A person who feels safe enough to relax. A family member who isn't holding their breath all day wondering if help will show up.

You'll be there when people need help with things they used to do on their own—when they're frustrated, embarrassed, or grieving the loss of independence. In those moments, good care is not just about completing tasks. It's about how you deliver them: with patience, consistency, and genuine respect for the person in front of you.

Every shift you work has the capacity to make someone's day better—or worse. We trust you with that responsibility, and we will hold you to it.

About the Agency

Silver Home Care is a locally owned non-medical home care agency based in Fairless Hills, PA. We serve families throughout Bucks and Philadelphia counties with a hands-on approach—because we're not just building a business. We're invested in the people we serve, the caregivers we employ, and the community we're part of.

We provide non-medical home care services. This means Direct Care Workers support daily living needs but do not perform medical or nursing tasks. Our services are available to clients who pay privately, use most long-term care insurance plans, or receive Veterans benefits. We are also contracted with Pennsylvania's Community HealthChoices (CHC) program.

Organizational Structure

Kelly Schmunk, Administrator

Oversees day-to-day operations. Hands-on and accessible.

Patti Carvalho, Staff Supervisor

Your main point of contact for scheduling, questions, and support.

Bruce Carvalho, Billing & Compliance

Handles billing, payroll, compliance, and administrative operations.

Shanell Day, Office Support

Supports office and field staff, including delivering supplies.

In-Home Services We Provide

Companion Care

Focuses on connection and presence. Engaging in conversation, encouraging hobbies, providing social interaction, and helping reduce loneliness. This is not medical care and it is not babysitting—it is a professional service that provides social and emotional support while maintaining client safety.

Homemaking Services

Light housekeeping, laundry, meal preparation, shopping, or running errands. You are supporting the client, not taking over their household. Tasks should be completed according to the client's preferences when it is safe to do so.

Personal Care (Medication Reminders Only)

Assistance with bathing, dressing, grooming, toileting, mobility, and eating. Personal Care should always be delivered in a way that supports independence and preserves dignity.

IMPORTANT: You may provide medication reminders only. You must never pour, measure, or administer medication.

Respite Care

Provides temporary relief for family caregivers while ensuring the client continues to receive safe and consistent care. When you provide respite services, you are stepping in so a family member can rest, attend appointments, or manage other responsibilities.

Part II: Client Rights, Professional Conduct & Confidentiality

Client Rights and Person-Centered Care

At Silver Home Care, our work is guided by the principle of person-centered care. This means we do more than complete a list of tasks—we focus on the client's goals, preferences, and choices. These rights are protected under Pennsylvania regulations (28 Pa. Code § 611.57 and 55 Pa. Code § 52.11).

What This Means Day-to-Day:
  • Respect client preferences around scheduling, routines, and how care tasks are carried out
  • If a client refuses a task, document it in HHAeXchange and notify the office if it affects safety
  • Always knock before entering private areas and remain mindful of privacy
  • Encourage independence whenever possible—even when it takes a little longer

Important: Person-centered care does not mean doing whatever a client asks. It means balancing respect for the individual with the boundaries and structure of the care plan and agency policies.

Professional Conduct and Boundaries

Professionalism at Silver Home Care is about consistency and judgment, not formality. When you enter a client's home, you represent the agency, and the way you speak, act, and carry yourself shapes the client's experience of care.

Do:
  • • Be warm and engaged
  • • Focus on the client's needs
  • • Maintain respectful conversations
  • • Stay professional and appropriate
Don't:
  • • Share personal struggles
  • • Debate politics or religion
  • • Get pulled into family conflicts
  • • Become personally entangled

Confidentiality & HIPAA

As a Direct Care Worker, you will learn private details about a client's health, routines, and personal life. That information must stay protected. You may only share it with authorized Silver Home Care staff and only for legitimate care or safety reasons.

Never Permitted:
  • • Discussing clients with friends or family
  • • Sharing client information on social media
  • • Talking about clients in public settings
  • • Leaving papers with private information visible
  • • Using unsecured devices to access client information

Financial and Legal Boundaries

Financial and legal boundaries deserve special attention because good intentions can still lead to serious problems.

Direct Care Workers May NOT:
Borrow or lend money
Accept valuable gifts
Use client's debit/credit card
Withdraw money
Be added to client's accounts
Act as power of attorney
Sign documents on behalf of client
Take sides in family disputes

If you are ever unsure whether something crosses a boundary, pause and contact your supervisor or the office for guidance.

Part III: Safety & Protection

Infection Control and Hygiene

Infection control is taken seriously because the clients we serve are often older adults or medically fragile. Something minor for you—like a cold—can pose a serious risk to someone with a weakened immune system.

Hand Hygiene

Wash hands with soap and water:

  • • Before and after every care task
  • • Before preparing food
  • • After using the bathroom
  • • After removing gloves
  • • Any time hands are visibly dirty
Personal Protective Equipment (PPE)

Use correctly:

  • • Gloves required for personal care
  • • Gloves required for toileting tasks
  • • Gloves required with bodily fluids
  • • Masks when required by care plan
  • • Never reuse gloves across tasks
Your Personal Hygiene

Wear your Silver Home Care uniform top and arrive clean and neat, without strong odors such as smoke or heavy perfume. This is part of showing respect to clients and maintaining a professional presence.

Workplace Safety and Hazard Communication

Chemical Safety
  • • All cleaning products must be properly labeled
  • Never mix bleach and ammonia - creates dangerous fumes
  • • Store chemicals safely away from food
Home Hazards

Report to the office if you notice:

  • • Loose rugs or cluttered walkways
  • • Poor lighting or unsafe wiring
  • • Oxygen equipment concerns
  • • Any hazard that puts you or the client at risk
Safe Body Mechanics
  • • Never lift more than 20 pounds without assistance
  • • Use proper techniques for transfers
  • • If a task feels unsafe, stop and ask for guidance
Workplace Injury

If you are injured while working, report the injury to the office immediately so the appropriate workers' compensation process can be followed.

Abuse, Neglect, and Exploitation Reporting

As a Direct Care Worker, you are a mandated reporter under Pennsylvania law. If you ever see, hear, or suspect abuse, neglect, or exploitation, you are required to report it.

Abuse

Physical, verbal, emotional, sexual, or financial harm

Neglect

Failure to provide basic needs: food, hygiene, safety, medical attention

Exploitation

Financial manipulation, stealing, pressuring to sign documents

If You Suspect Abuse, Neglect, or Exploitation:
1

Make sure the client is safe in the moment

2

Contact the office immediately to report what you observed

3

Document your observations in HHAeXchange using clear, factual language

4

Complete an incident or complaint form the same day

You are not responsible for investigating or proving abuse. Your responsibility is to report concerns so the appropriate agencies can respond. Failing to report suspected abuse is a violation of both the law and agency policy.

Critical Incidents and Emergency Preparedness

When to Call 911 Immediately
Fall with injury
Loss of consciousness
Difficulty breathing
Chest pain
Severe bleeding
Seizure

After calling 911: Stay with the client, follow dispatcher's instructions, and notify the office once emergency services are on the way.

Incident Reporting Sequence
  1. 1. Safety First: Make sure the client is safe. If urgent or life-threatening, call 911
  2. 2. Call the Office: As soon as possible, give a clear, factual summary
  3. 3. Document: Report in HHAeXchange and complete incident form the same day
  4. 4. Report Near Misses: Even if harm was narrowly avoided, report it to prevent future incidents
Fire Emergency
  • • Know exits in the client's home
  • • If you smell smoke or see fire, evacuate if safe
  • • Call 911 once outside
  • • Never re-enter the home
Severe Weather
  • • Remain with client until safe to leave
  • • If travel is unsafe, contact office
  • • Never risk your safety without clearance
Client Abandonment

Client abandonment is one of the most serious violations of Silver Home Care's standards. Abandonment occurs when a client is left without care during a scheduled visit—whether by not showing up, leaving early without authorization, or leaving without proper coverage or notification.

If you are running late, cannot make it, or encounter an emergency, contact the office immediately. Do not call the client directly. Abandonment can result in immediate termination and may carry legal consequences.

Part IV: Employment Standards & Policies

Senior Caucasian woman using walker for support walking indoors accompanied by Black man holding laptop, both interacting and smiling in modern home living space

These standards apply to every Direct Care Worker. They are non-negotiable because client safety and quality care depend on them.

Attendance & Punctuality

Punctuality is not just about arriving on time. It's about reliability. Clients and their families plan their days around your schedule. Being late disrupts their lives and creates unnecessary stress and uncertainty.

Arrive ready to work at the scheduled start time. If you know you will be late, contact the office immediately—not the client.

Attendance Expectations
  • • No more than 3 absences in 90 days
  • • Call office ASAP if you can't work
  • • Never call out directly to client
  • • Repeated tardiness = disciplinary action
Emergency Absences
  • • Call as soon as you know you can't work
  • • Provide honest, direct communication
  • • Documentation may be required
  • • We understand emergencies happen

Dress Code & Personal Hygiene

Required
  • • Silver Home Care uniform top
  • • Clean, professional pants
  • • Closed-toe shoes
  • • Name badge visible
Not Permitted
  • • Ripped or stained clothing
  • • Tank tops, shorts, leggings
  • • Strong perfume/cologne
  • • Visible undergarments
Hygiene
  • • Arrive clean and neat
  • • Hair secured away from face
  • • Nails clean and trimmed
  • • No smoke odor

Cell Phone & Earbud Policy

When you're with a client, you are there to provide care—not to scroll through your phone. Phones are tools for work communication, not personal entertainment.

Acceptable Use
  • • Clocking in/out via EVV system
  • • Contacting the office for work matters
  • • Checking messages during breaks (if applicable)
  • • Emergency personal calls (briefly, with notification)
Not Permitted
  • • Texting, browsing, or social media
  • • Personal calls during care time
  • • Earbuds or headphones at any time
  • • Taking photos or videos

Violations of this policy will result in progressive discipline: verbal warning, written warning, suspension, and termination. This is a client safety issue.

Part V: Documentation & Electronic Visit Verification (EVV)

Good documentation is a core part of your job. When done correctly, it protects you, the client, and the agency.

Silver Home Care uses HHAeXchange for EVV and documentation. You will download the app, clock in and out at the client's home, and complete visit notes daily.

Careful nurse assisting a senior man while using digital tablet on patio in nursing home. Happy nurse and senior patient sitting on wheelchair watching video on digital tablet. Young healthcare professional helping an elderly man use a digital device.

How to Use the EVV System

Step 1: Clock In
  • • Open HHAeXchange app on your phone
  • Wait until you are inside the client's home and have greeted the client
  • • Tap "Clock In" and confirm your location
  • Do NOT clock in from your car, from outside the home, or before seeing the client
Step 2: Provide Care
  • • Follow the client's care plan
  • • Complete assigned tasks
  • • Pay attention to any changes in the client's condition
  • • Stay engaged and present throughout the visit
Step 3: Document Your Visit
  • • Before leaving, complete your visit notes in HHAeXchange
  • • Describe what you did during the visit
  • • Note any concerns, refusals, or changes
  • • Be clear, factual, and professional
Step 4: Clock Out
  • • After documentation is complete, tap "Clock Out"
  • Do NOT clock out before you are ready to leave
  • • Make sure your hours are correct before submitting

What to Do When Something Goes Wrong

If You Forget to Clock In or Out

This is called a "missed punch." It happens. Here's what to do:

  • • Contact the office as soon as you realize
  • • Provide your actual arrival and departure times
  • • The office will verify with the client or family
  • • Your timesheet will be corrected
If the App Won't Work
  • • Check your internet connection
  • • Make sure location services are on
  • • Try closing and reopening the app
  • • If still not working, call the office immediately
  • • Write down your actual time and report it

Documentation Standards

What Good Documentation Looks Like

✓ Clear and specific:

"Assisted with shower. Client used grab bars and tolerated well."

✗ Vague and unhelpful:

"Helped client."

Critical: Time Fraud Prevention

Clocking in when you're not at the client's location, or clocking in and then leaving, is fraud. It is a violation of Medicaid regulations and Pennsylvania law.

  • • You must be physically present in the client's home after greeting them before clocking in
  • • You must stay for the entire scheduled shift
  • • GPS verification is used to confirm your location
  • • Falsifying time can result in termination and criminal prosecution

Part VI: Training Requirements

Home healthcare nurse assisting a senior man holding a walking cane, providing support and care in his living room

Pennsylvania regulations require ongoing training for all Direct Care Workers. Your continued employment depends on maintaining compliance with these requirements.

Pre-Service Orientation (Before First Shift)

You must complete the following before being assigned to any client:

  • This written orientation guide
  • Orientation videos (5 required videos)
  • Acknowledgment forms confirming you understand policies
  • Demonstration of EVV system use

Annual Training Requirements

Infection Control

Hand hygiene, PPE use, disease prevention

Abuse Reporting

Recognizing and reporting suspected abuse or neglect

Emergency Response

What to do in medical or safety emergencies

When: Training is assigned annually and must be completed within 30 days of notification. Failure to complete required training may result in removal from the schedule.

Health & Safety Compliance

TB Testing

Two-step tuberculosis skin test required upon hire. Annual single-step test required thereafter. Results must be submitted to the office before starting work.

Physical Exam

Required before hire and annually thereafter. Must include verification that you are physically capable of performing the job and free of communicable diseases.

CPR Certification (Recommended)

While not always required, CPR certification is strongly encouraged and may be required for certain assignments.

Part VII: Employment Lifecycle

Compensation & Payroll

Pay Schedule

Paychecks are issued weekly, every Friday.

  • • Direct deposit is strongly encouraged
  • • Time is calculated from EVV system
  • • Review your hours weekly in HHAeXchange
Questions About Pay

Contact the office if you notice discrepancies.

  • • We aim to resolve payroll issues quickly
  • • Always keep your bank info up to date
  • • Report missed hours immediately

Performance & Discipline

We believe in clear expectations and direct feedback. If there's a problem, we'll address it with you directly. Our progressive discipline policy provides structure while allowing room for improvement.

Step 1

Verbal Warning

Step 2

Written Warning

Step 3

Suspension

Step 4

Termination

Immediate Termination Offenses

Some violations are serious enough to warrant immediate termination:

  • • Client abandonment
  • • Fraud or time theft
  • • Abuse or neglect of a client
  • • Theft from a client or agency
  • • Working under the influence of drugs or alcohol

If You Decide to Leave

If you need to resign, we ask for at least two weeks' notice. This gives us time to adjust client schedules and minimize disruption to the people who depend on you.

We understand that circumstances change. If you leave on good terms, you're always welcome to return if life brings you back this way.

Part VIII: Glossary & Important Contacts

Hands holding old woman's hands

You're Ready

This orientation covered a lot. Don't expect to remember everything on day one. What matters most is that you understand the expectations, know where to find help when you need it, and show up ready to do right by the people you serve.

Acknowledgment and Signature

All Direct Care Workers are required to sign the Orientation Acknowledgment Form. This form confirms that you have:

  • Received and reviewed the Silver Home Care Orientation Guide
  • Understand your responsibilities as outlined in agency policies and procedures
  • Agreed to follow Silver Home Care's rules, standards, and expectations
  • Received required information regarding client rights, abuse reporting, confidentiality, HIPAA, and workplace safety

The signed acknowledgment is maintained in your personnel file, as required by regulation (28 Pa. Code § 611.56; 55 Pa. Code § 52.21).

Closing Statement

We hired you because we saw something in you that matters—you're kind, you're reliable, and you understand that treating people with respect and dignity isn't optional. Those qualities are exactly what this work requires.

At Silver Home Care, every visit is more than a task. It is an opportunity to improve someone's life by providing steady, respectful, and thoughtful care in their own home. The work you do makes a real difference—one visit at a time.

By following the guidance in this Orientation Guide, respecting client rights, and maintaining professional standards, you play a direct role in creating safety, dignity, and continuity for the people we serve.

Thank you for choosing this work and for being part of Silver Home Care. We're glad you're here, and we're here to support you every step of the way.

Glossary of Terms

Abuse

Any action that causes harm, including physical, emotional, sexual, or financial harm. Direct Care Workers are mandated reporters of suspected abuse.

ADA (Americans with Disabilities Act)

Federal law prohibiting discrimination against individuals with disabilities and requiring reasonable workplace accommodations.

Care Plan

A written document prepared by Silver Home Care that outlines approved services, client needs, and specific instructions. All services must follow the care plan exactly.

Chapter 52

Pennsylvania regulations (55 Pa. Code Chapter 52) governing home and community-based services.

Chapter 611

Pennsylvania regulations (28 Pa. Code Chapter 611) governing home care agencies and registries.

Client (Participant)

The individual receiving services from Silver Home Care. "Participant" is the term used in Medicaid regulations.

Client Abandonment

Leaving a client without care during a scheduled shift. Considered a serious violation that may result in termination.

Competency

The demonstrated ability to perform caregiving duties safely and effectively, as required by regulation and agency policy.

Confidentiality

The obligation to protect private client information in compliance with HIPAA and Silver Home Care policy.

Direct Care Worker (DCW)

An employee of Silver Home Care who provides non-medical services and support to clients in their homes.

Electronic Visit Verification (EVV)

A federally mandated system used to record the start and end of home care visits through GPS-enabled mobile technology.

Exploitation

The illegal or improper use of a client's resources, property, or person for personal gain.

HHAeXchange

The mobile application used by Silver Home Care for EVV, task documentation, and visit notes.

HIPAA

The Health Insurance Portability and Accountability Act, a federal law protecting the privacy and security of health information.

Mandated Reporter

A professional legally required to report suspected abuse, neglect, or exploitation. All Direct Care Workers at Silver Home Care are mandated reporters under Pennsylvania law.

Missed Punch

A failure to clock in or out in the EVV system. Requires immediate contact with the office and submission of a Missed Punch Form.

OIG Exclusion List

A federal list identifying individuals barred from participating in federally funded health programs. Individuals on this list cannot work in Medicaid-funded services.

Overnight Awake Requirement

A Community HealthChoices (CHC) rule requiring Direct Care Workers assigned to overnight shifts to remain awake for the entire shift, with required check-ins at designated times.

PPE (Personal Protective Equipment)

Equipment such as gloves or masks used to reduce the risk of infection.

Provisional Hire

A Direct Care Worker who begins employment under supervision while background checks are pending, in compliance with Pennsylvania law.

Whistleblower

A worker who reports suspected fraud, abuse, or safety violations and is protected from retaliation under state and federal law.

Important Contacts

Office Main Line

(215) 123-4567

Mon-Fri, 8:00 AM - 5:00 PM

After-Hours Emergency

(215) 123-4567

Nights, weekends, holidays

HHAeXchange Support

1-877-262-5427

For app/technical issues

Report Abuse

1-800-490-8505

PA Adult Protective Services

Welcome to Silver Home Care

You're about to step into someone's home, someone's routine, and someone's life. That's a privilege. Treat it like one.

Thank you for choosing to be part of this work. We're glad you're here.