Weekly Caregiver Log

Weekly Caregiver Log

Log weekly client care activities and tasks. Please complete all relevant sections for the week. Attendant Care shifts require hourly charting. Hourly charting can be completed in the notes section.
Example of hourly charting: Shift 8AM - 12PM

8am-9am - sleeping, 9am - 10am prepare meal and ate, 10am - 11am assist with shower, 11am - 12pm laundry
General Information
Employee
Client Name
Week Ending (Date)

MonthDayYear
Date
Week Ending (Year)
Daily Log
Monday Log
Tuesday Log
Wednesday Log
Thursday Log
Friday Log
Saturday Log
Sunday Log
Care Tasks Checklist

Attendant Care, Homemaking, and Companion Services Checklist

Rows	Mon	Tue	Wed	Thu	Fri	Sat	Sun
Activity Level/Mobility
Assistance with Transfer
Bathing Assistance
Dressing/Grooming Assistance
Hair Care Assistance
Medication Reminders
Nail Care (no diabetics)
Oral Care Assistance
Shaving Assist (blood thinners?)
Toileting Assistance
Change Bed Linen
Clean Bathroom
Clean Kitchen
Cooking
Dust
Laundry
Living Areas
Vacuum/Sweep/Mop
Errands/Shopping
Recreational Activities
Transportation
Appointment
Exercise
Other Services Row 1
Other Services Row 2