Caregiver Shadowing Form
Evaluate a caregiver's performance during a shadowing observation using this assessment form.
Punctuality
*
1
2
3
4
5
Professional Appearance
*
1
2
3
4
5
Communication Skills
*
1
2
3
4
5
Interaction with Client
*
1
2
3
4
5
Adherence to Protocols/Procedures
*
1
2
3
4
5
Teamwork and Cooperation
*
1
2
3
4
5
Initiative and Problem Solving
*
1
2
3
4
5
Would you recommend this caregiver for independent shifts?
*
Yes
No
Needs further observation
Areas for Improvement
Additional Comments
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Should be Empty: