Preceptor Evaluation Tool Question Title * 1. Preceptor (Your) Full Name: OK Question Title * 2. New Hire's Full Name: OK Question Title * 3. Punctuality Additional Comments: OK Question Title * 4. Stayed full amount of allotted time for client Additional Comments: OK Question Title * 5. Uses 2 factor authentication Additional Comments: OK Question Title * 6. Checks and responds to voicemail Additional Comments: OK Question Title * 7. Reliably does assigned tasks Additional Comments: OK Question Title * 8. Logs in/out with mobile phone Additional Comments: OK Question Title * 9. Understands and follows directions Additional Comments: OK Question Title * 10. Consistently wears Circle of Care ID Additional Comments: OK Question Title * 11. Wears proper worker attire/footwear Additional Comments: OK Question Title * 12. Has appropriate level of conversation with client/family Additional Comments: OK Question Title * 13. Shows an understanding of professional boundaries Additional Comments: OK Question Title * 14. Respectful of colleagues and clients Additional Comments: OK Question Title * 15. Reports concerns effectively to the office (NFV, Refused Visit, etc.) Additional Comments: OK Question Title * 16. Seeks and responds to guidance Additional Comments: OK Question Title * 17. Shows interest and initiative Additional Comments: OK Question Title * 18. Is client-centered at all times; Uses Service with Heart Additional Comments: OK Question Title * 19. Provides a safe environment for client Additional Comments: OK Question Title * 20. Adheres to Circle of Care policies and procedures Additional Comments: OK Question Title * 21. Communicates with client clearly during personal care Additional Comments: OK Question Title * 22. Asks critical care questions Additional Comments: OK Question Title * 23. Showed appropriate involvement of family members or colleagues during care Additional Comments: OK Question Title * 24. Followed the care plan Additional Comments: OK Question Title * 25. Cleaned and tidied bathroom/kitchen after use Additional Comments: OK Question Title * 26. How well were the duties performed Poor Fair Good Excellent N/A toileting & incontinence products toileting & incontinence products Poor toileting & incontinence products Fair toileting & incontinence products Good toileting & incontinence products Excellent toileting & incontinence products N/A dressing client dressing client Poor dressing client Fair dressing client Good dressing client Excellent dressing client N/A personal hygiene (hair care, mouth care, shaving – electric razor only) personal hygiene (hair care, mouth care, shaving – electric razor only) Poor personal hygiene (hair care, mouth care, shaving – electric razor only) Fair personal hygiene (hair care, mouth care, shaving – electric razor only) Good personal hygiene (hair care, mouth care, shaving – electric razor only) Excellent personal hygiene (hair care, mouth care, shaving – electric razor only) N/A laundry laundry Poor laundry Fair laundry Good laundry Excellent laundry N/A meal/preparation meal/preparation Poor meal/preparation Fair meal/preparation Good meal/preparation Excellent meal/preparation N/A medication reminder medication reminder Poor medication reminder Fair medication reminder Good medication reminder Excellent medication reminder N/A shower/sponge bath shower/sponge bath Poor shower/sponge bath Fair shower/sponge bath Good shower/sponge bath Excellent shower/sponge bath N/A light cleaning light cleaning Poor light cleaning Fair light cleaning Good light cleaning Excellent light cleaning N/A OK Question Title * 27. Additional Comments: OK DONE