Choose the care record that matches today's assigned service.

Attendant Care and Homemaker/HCA use separate daily duty forms. Select only the form assigned to your position and authorized in the client's current service plan.

Choose a charting form Transportation Staff Portal

Transportation is separate

Authorized drivers must use the Transportation Staff Portal for trip and mileage records. Do not use a daily care form.

Go to Transportation Portal

Before you begin

Confirm these four items

If any item is incorrect or unclear, stop and contact the office before charting.

1
Correct client
Confirm the client name and record number.
2
Authorized service
Review the current T4-1 service plan.
3
Exact visit time
Match the charting period to the GEOH EVV record.
4
Assigned role
Use only the form assigned to your position.

Step 2

Select your assigned care service

One form covers the complete daily duty and includes a separate charting entry for each hour worked.

T4-1ADaily duty record

Attendant Care

Personal Care Attendant or Caregiver

Use for authorized hands-on support, cueing, supervision, and approved activities of daily living.

Complete one submission for the full daily shift.
Document the actual activity and outcome for every hour.
If an hourly block includes less than 60 actual minutes, explain the difference in the hourly note.

Open Attendant Care Form

T4-1BDaily duty record

Homemaker / HCA

Homemaker or Home and Community Assistance Worker

Use for authorized IADL services, including meal preparation, housekeeping, laundry, and essential errands.

Enter the Approved HCA Schedule for Today.
Document the authorized IADL task and outcome for every hour.
Do not use this form for hands-on personal care or a transportation trip record.

Open Homemaker/HCA Form

Client signature is not required on these digital daily duty forms. Staff attestation and GEOH EVV are still required.

Documentation standard

Write what actually happened.

Notes must be factual, individualized, and connected to the authorized service. Do not copy an earlier note or document work that was not completed.

Good hourly note“MP: Prepared the authorized lunch and placed it in a labeled container in the refrigerator for later use.”

When help is needed

Protect the audit trail

Correction or late entry

Do not delete or overwrite the original record. Submit a linked correction and state what is being corrected, why, and the original service date.

Request correction support

Stop and contact the office

Contact the office for an authorization question, EVV mismatch, refused or missed task, condition change, safety concern, or unusual incident.

Call 317-377-4134

Emergency or immediate danger

Call 911 first for an immediate threat to life or safety. Notify the agency after emergency help has been requested.

Call 911

Protect client information

Use an authorized account and a secure device. Do not share portal links, passwords, screenshots, or client information with an unauthorized person.

Top Notch Care LLC, Indianapolis, Indiana

Non-Medical Transportation: safe assistance entering/exiting a passenger minivan

Personal Care Attendant: respectful dressing and grooming support

Homemaker/HCA: meal preparation, groceries, and laundry in a client’s home