Home Health Aide Skills Checklist
This form assist to identify home health aide training and orientation.
Aide Name
Name
Last Name
E-mail
example@example.com
Vital Signs
Rows
Unfamiliar
Familiar
Practiced
Expert
Temperature - oral
1
2
3
4
Temperature - rectal Â
5
6
7
8
Pulse - Apical
9
10
11
12
Blood Pressure
13
14
15
16
Containing respirations
17
18
19
20
Personal Care
Rows
Unfamiliar
Familiar
Practiced
Expert
Bed Bath
21
22
23
24
Sponge Bath
25
26
27
28
Tub Bath
29
30
31
32
Shower
33
34
35
36
Nail and Skin Care
37
38
39
40
Oral Hygiene
41
42
43
44
Swab
45
46
47
48
Denture Care
49
50
51
52
Shave
53
54
55
56
Assist with Dressing
57
58
59
60
Elimination
Rows
Unfamiliar
Familiar
Practiced
Expert
Use of Bed Pan
61
62
63
64
Bowel Program
65
66
67
68
Use of Bedside Commode
69
70
71
72
Measure Urine Output
73
74
75
76
Empty Foley Catheter Drainage
Bag
77
78
79
80
Safe Transfer Technique
Rows
Unfamiliar
Familiar
Practiced
Expert
Range of Motion
81
82
83
84
Repositioning in Bed
85
86
87
88
Walker
89
90
91
92
Hoyer Lift
93
94
95
96
Assist with Ambulation
97
98
99
100
Care Experience
Rows
Unfamiliar
Familiar
Practiced
Expert
Care of Alzheimer Client
101
102
103
104
Care of Client with
Respiratory Difficulties
105
106
107
108
Care of Client with Stroke
109
110
111
112
Care of Client with Head
Injury
113
114
115
116
Care of the Paraplegic
or Quadriplegic Client
117
118
119
120
Diabetic Care
121
122
123
124
Care of the Amputee Client
125
126
127
128
Care of Bed Bound Client
129
130
131
132
Housekeeping Duties
Rows
Unfamiliar
Familiar
Practiced
Expert
Washing Clothes
133
134
135
136
Folding Clothes
137
138
139
140
Dishes
141
142
143
144
Mop Floors
145
146
147
148
Dusting
149
150
151
152
Grocery Shopping / Errands
153
154
155
156
Assist with Feeding
157
158
159
160
Special Diet Instructions
161
162
163
164
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Aide's Score
Submit
Should be Empty: