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Get and Sign Homemaker Time and Activity Documentation AbbeyCare Inc Form
Kitchen/Dishes Bathroom s Empty Wastebaskets Make Bed/Change Linen Shopping/Errands Companionship/Social Stimulation Meal Preparation Assistance with Activities of Daily Living Monitor the Safety and Well Being DAY OF THE WEEK DATE Time In Circle AM/PM Time Out Daily Total MONDAY AM PM TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY TOTAL Acknowledgement and Required Signatures After the Homemaker has documented his/her time and activity the recipient must draw a line through any dates and...
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