The first month of hired home care runs as a sequence. Each step has an owner and produces a document. When a step is skipped, the gap shows up later as a missed visit or a question nobody can answer. The sequence below runs from the first call to the review call, and the families who keep the document from each step have the clearest record when the schedule changes.

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Step one: the intake call

The intake call records the basic facts: who lives in the home, who the family contact is, the days and hours wanted, the services wanted, and how the aide will get into the home. The family contact owns this step. The output is a written intake summary that the family reads back and corrects before it is filed. If the agency asks about health conditions, give only what the agency needs for scheduling and send any health questions to the family's doctor.

Step two: the assessment visit

An assessment visit is a walk through the home with the agency's coordinator present. Walk each room, floor, and entry with the coordinator, and mark each task the family does itself. The agency owns the visit. The output is a written task list, a proposed schedule, and a list of tasks the agency will not do. Do not sign until the task list matches what was walked.

Step three: the shadow shift

A shadow shift puts the assigned aide in the home with a family member present before the aide works alone. The family and the agency own this step together. The output is a short note of what the family corrected, what the aide missed, and what the aide already knew about the house. Ask how the aide will record each visit, and how the next aide will be briefed on the home if this one is replaced.

Step four: the first full week

The first full week is the test window. The family checks arrival times, completed tasks, and whether calls were answered when plans changed. The family owns this step. The output is a visit log that records the time each visit started, the tasks completed, and anything left undone. Keep the log where every person in the home can see it.

Step five: the review call

The review call goes on the agency's calendar at the start of the process, not left to chance. The coordinator and the family contact own it. The output is a list of changes to the task sheet, the schedule, or the contacts, and a date for the next review. Ask whether the coordinator will attend a visit in person, and ask who the family calls when the assigned aide is out.

Questions to ask at each step

At intake: who signs the summary, and when is it sent? At the assessment: which tasks are excluded, and where in the paperwork is that written? At the shadow shift: who decides whether the aide keeps the assignment? In the first week: what happens when a visit is late? At the review: which document changes when the schedule changes?

Plan the month

Week one: the intake call and the written summary. Week two: the assessment visit and the signed task list. Week three: the shadow shift and the first days of the visit log. Week four: the review call and the first set of written changes.

When the agency reports thin staffing for the days you need, the county notes in How to read a caregiver-supply map for your county explain what the staffing picture means for your area.