When issues arise that prevent the EVV App from being used, an adjustment to the shift or a manual time entry will need to be made using this form. Employees will need to fill out the information below and a member from our admin team will need to review and approve the form. 

By signing this timesheet, I declare under penalty of perjury that the hours reported above are true, completed and correct; represent all my actual work time; and were verified by the Client or Responsible Party. I further attest under penalty of perjury that during this pay period I adhered to all the policies of Choice Home Care, Inc; received the meal and or rest periods to which I was entitled, if any. During any shift when I worked in the private home of a Choice Home Care client, I declare under penalty of perjury that I (1) performed only non-medical personal attendant companionship services; (2) spent at least 80% of my time supervising, feeding and or dressing the client; and (3) did not perform any medical procedures or administer medication, or drive the client in mine or anyone else’s vehicle. Finally, if I remained at a client’s home during my non-working hours, I declare under penalty of perjury that I (1) did not work (unless I otherwise notified Choice Home Care on my timecard) and was not on call during my non-working hours; (2) was relieved of all duties and not required to remain on the premises or respond to the client during my non-working hours.