CareLiving, LLC
Service Agreement
The parties to this Service Agreement are _____________________________________________________________ ("client(s)" )
and CareLiving, LLC, ( "caregiver" ) _________________________________________.
The purpose of this agreement is to set out the terms of services rendered and to establish what assistance the Caregiver will provide to the Client.
Client is a person of limited or impaired abilities as set forth or described on the ADL Assessment document. Caregiver will assist Client to live at home and will provide care and assistance in accordance with the ADL Assessment agreed upon services. Caregiver will take special care to allow Client to have as much control over the home environment and life as possible. As circumstances arise, the ADL Assessment will remain a "work in progress" for evaluation purposes, updated or amended assistance requirements and as a report to those family members or responsible party, as required.
Client shall furnish Caregiver all necessary family / responsible party / doctors phone numbers, physician / medication instructions,
and necessary access required to meet assistance needs. Caregiver will maintain written records of days and times of service, any accidents or emergencies and any unusual behaviors should they occur.
Caregiver will provide transportation for Client in Client's vehicle. Caregiver will provide proof of liability and uninsured motorist insurance and property damage coverage. Client shall provide reciprocal proof of vehicle insurance.
Caregiver shall be "on call", though notice of appointments, errands, shopping etc are anticipated. There will be no charge for canceled services. Our policy of "No Service, No Charge" is always in force.
This Service Agreement may be terminated by either the Client or the Caregiver with two (2) weeks advance written notice. Client and / or Caregiver may terminate this agreement without notice due to "cause". "Cause" is defined as unethical behavior, abuse, either physical or verbal, absenteeism, unwillingness to follow ADL Assessment guidelines, unsafe driving practices, dishonesty, failure to provide records / reports, extreme changes in Client's condition, requiring care beyond the scope of Careliving's licenses.
The hours and hourly compensation of Caregiver are subject to change at any time as agreed upon between Caregiver and Client ( or Client's representative ). The initial arrangement is as follows:
Date of Service Agreement: _____________
Days / Hours
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
_________/_________/__________/_____________/___________/_________/___________
As Needed ( on call ) _______ Compensation ____________
Client(s) ___________________________________________________ CareLiving Caregiver _______________________
Family / Agent _____________________________________________
Addendum: ADL Assessment