Home Health Visit Quality Review Checklist
A supervisory review of an in-home skilled or personal care visit. It captures whether the caregiver arrived on time, completed the assigned care plan tasks, followed infection control, and documented the visit properly.
Who uses it and how often
- Used by
- Home health agency supervisors and clinical managers performing field observations.
- Frequency
- Per caregiver on a recurring interval, commonly every 60 or 90 days.
The checklist (11 questions)
Supervisory review of an in-home skilled or personal care visit.
- 01
Client name
Short textRequired - 02
Visit date
DateRequired - 03
Caregiver arrived within the scheduled window?
Yes / No / N/ARequired - 04
Visit duration (minutes)
NumberRequired - 05
Caregiver wearing ID and appropriate uniform/PPE?
Yes / No / N/ARequired - 06
All assigned tasks completed?
Yes / No / N/ARequired - 07
Vitals recorded where required?
Yes / No / N/ARequired - 08
Hand hygiene and infection control observed?
Yes / No / N/ARequired - 09
Visit documentation complete and signed?
Yes / No / N/ARequired - 10
Client feedback
Long textOptional - 11
Supervisor signature
SignatureRequired
How to run this inspection
- 01
Log the client, visit date, and caregiver being observed.
- 02
Score arrival, care plan task completion, and infection control practice.
- 03
Check that documentation matches what was actually performed.
- 04
Collect client feedback and record any corrective action needed.
Run it on a phone instead of paper
Open this checklist in FormFlow QA to schedule it against your sites, assign it to your team, attach photos and signatures, and keep every submission encrypted and searchable. There is a free plan during beta.