Publications PASGuide 20190318

PERSONAL ASSISTANCE SERVICES (PAS)
2002
STATE OF CALIFORNIA
GRAY DAVIS, GOVERNOR
HEALTH AND HUMAN SERVICES AGENCY

GRANTLAND JOHNSON, SECRETARY
DEPARTMENT OF DEVELOPMENTAL SERVICES

CLIFF ALLENBY, DIRECTOR
INTRODUCTION
Personal assistance services (PAS) are used to help a person with a disability do tasks
that he or she would normally do if there was no disability. The use of PAS in supported
living services are often the key to a person being able to successfully live in the home of
his or her choice. The focus of this document is PAS for adults with developmental
disabilities who choose to live in their own home with supported living services.
This guide is not a prescription for the best way to do PAS. There are many "best ways"
because personal assistance services are as individual as each person receiving the
services. It's a sharing of some thoughts on how to reach what is best for you or the
person you are serving. It's a guide to planning, hiring, training and retaining the very
important people who provide personal assistance. It also provides real life examples in
the Appendix.
It is important to remember that laws applicable to employee/employer relationships,

interview questions, payroll, termination, etc., apply as they do in any business
transaction. Be sure to consult those laws and rules if you have questions about a
specific case.
To view the laws and regulations mentioned in the Personal Assistance Services guide,
please refer to the following Web sites.
California Welfare & Institutions Code (W & I Code)

Sections 4400 – 4903 (Lanterman Act)
http://www.leginfo.ca.gov/cgi-bin/calawquery?codesection=wic&codebody
The Lanterman Act begins at Division 4.1.
Sections 12300 – 12316

http://www.leginfo.ca.gov/cgi-bin/displaycode?section=wic&group=12001-
13000&file=12300-12316
Section 14132.95
http://www.leginfo.ca.gov/cgi-
bin/waisgate?WAISdocID=4875341729+0+0+0&WAISaction=retrieve
All California Statutes http://www.leginfo.ca.gov/calaw.html
Manual of Policies and Procedures (MPP)

http://www.dss.cahwnet.gov/ord/CDSSManual_240.htm.
The first numbers after MPP, e.g., MPP 30-, refer to a division of the California
Department of Social Services' Manual of Policies and Procedures.
(Rev. 2/02) i
TABLE OF CONTENTS
ABBREVIATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
DEFINITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
WHO is in charge? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
WHAT kinds of services? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
WHERE does the money come from? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
PLANNING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Assessing Support Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Meeting Support Needs and Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Health and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Living Arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Characteristics of a Personal Assistant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
RECRUITING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
How Are You Going to Recruit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
What to Include in Advertisements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Telephone Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Conviction of a Crime . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Scheduling the Interview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
THE INTERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Conviction of a Crime . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Criminal Record Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Pay and Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Questions NOT to Ask . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Hiring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
TRAINING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
ABOUT TRUST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
COMMUNICATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
HOW TO DISMISS AN ASSISTANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
(Rev. 2/02) ii
APPENDIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Ad For Housemate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2
Flyer for Housemate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Guidelines For Accessing & Utilizing
Attendant Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4
Job Description for Attendant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-19
Instructions for Howard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-25
Sample Job Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-29
Guidelines for Fingerprint Card Submission . . . . . . . . . . . . . . . . . . . . . . . . . . . A-31
Emergency Preparedness Checklist for People with Disabilities . . . . . . . . . . . . A-33
Disaster Preparedness for People with Disabilities . . . . . . . . . . . . . . . . . . . . . . A-35
Resource Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-39
(Rev. 2/02) iii

ACRONYMS
Acronyms used in this document.
< CCR . . . . . . . . . . . . . . . . California Code of Regulations

< CDSS . . . . . . . . . . . . . . . California Department of Social Services
< DDS . . . . . . . . . . . . . . . . California Department of Developmental Services
< IHSS . . . . . . . . . . . . . . . In-Home Supportive Services
< IPP . . . . . . . . . . . . . . . . . Individual Program Plan
< MPP . . . . . . . . . . . . . . . . Manual of Policies and Procedures (CDSS)
< PCSP . . . . . . . . . . . . . . . Personal Care Services Program
< PAS . . . . . . . . . . . . . . . . Personal Assistance Services
< SLS . . . . . . . . . . . . . . . . Supported Living Services
< W & I Code . . . . . . . . . . . Welfare and Institutions Code
(Rev. 2/02) iv
DEFINITIONS
< Advance Payment (direct advance payment) is a payment to be used for the
purchase of authorized IHSS services which is sent directly to the consumer in
advance of the service actually being provided. [W & I Code 12304(a); MPP
30-753(d)(3)]
< Conservator is a person who is appointed by the court to protect and to

manage the affairs of another person.
< Consumer is an individual who meets the criteria for regional center services
and for whom the regional center provides services.
< Generic Agency means any agency which has a legal responsibility to serve all
members of the general public and which is receiving public funds for providing
such services. [W & I Code 4644(b)]
< Individual Program Plan (IPP) is a regional center document that records the
who, what, when and how others will work with a consumer to reach his or her
preferred future. The preferred future, based on the individual’s strengths,
capabilities, preferences, lifestyle and cultural background, is developed in a
collaborative effort by a planning team that includes the consumer, family (when
appropriate), regional center representatives and others.
< In-Home Supportive Services (IHSS) provides assistance to those eligible

aged, blind and disabled individuals who are unable to remain safely in their own
homes without this assistance. IHSS is an alternative to out-of-home care.
[MPP 30-700.1]
< Live-In Provider is a provider who lives in the consumer's home expressly for
the purpose of providing personal care services.
< Natural Supports means personal associations and relationships typically

developed in the family and community that enhance or maintain the quality and
security of life for people.
< Own Home means the place in which an individual chooses to reside. Own
home does NOT include: acute care hospital, skilled nursing facility,
intermediate care facility, community care facility, or board and care facility.
< Paramedical Services are activities that the consumer would normally provide
for him/herself but cannot due to physical limitations.
< Personal Assistance Services (PAS) provide help to a person with a disability
to do tasks that he or she would normally do if there was no disability.
(Rev. 2/02) v
< Personal Care Services Program (PCSP) provides personal care services
through the IHSS program to eligible Medi-Cal beneficiaries.
[MPP 30-700.2]
(Rev. 2/02) vi
OVERVIEW
(Rev. 2/02) 1
WHO is in charge?
THE CONSUMER IS IN CHARGE!
Consumer choice and preference are guiding principles of supported living. This
applies not only to the choice of where to live, but also to the choice of who provides
services. While supported living service (SLS) agencies may help find and interview
PAS providers as well as help facilitate the decision, consumer choice must guide the
selection. Of course, the consumer may choose anyone to help with the selection
process.
Failure of the relationship between a consumer and an assistant may be seen in a

number of different ways. If a consumer doesn't feel secure and safe with or doesn't
trust an assistant there may be less cooperation, less responsiveness, behavior
changes or some other indication of dissatisfaction. The consumer may be less willing
to share feelings, needs, medical concerns or other personal information with the
assistant that could affect his or her care. A consumer who doesn't look forward to an
assistant's company may become less willing to spend time with the assistant in
community or other activities.
A failing relationship also affects the assistant regardless of who is at fault. The
assistant may be less attentive, less patient, take time off without giving notice, etc.
Consumer abuse may be more likely under these situations.
CONSERVATOR
When the consumer is conserved, the conservator makes or guides the choice.
However, if the consumer can indicate a choice, the chances of a successful
relationship are better.
SUPPORTED LIVING SERVICES AGENCY
The SLS agency is responsible for putting together the services needed by the
consumer to live safely in the home of his or her choice and to participate in community
life, education, training, employment and other activities as specified in the IPP. This
includes whatever support the consumer needs to find, hire, train, or terminate those
persons who provide the personal assistance services.
(Rev. 2/02) 2
WHAT kinds of services?

Almost any service that is needed to help a consumer lead his or her preferred life qualifies
as PAS. These may be services provided in the home, at school, work and in community
activities. A consumer of regional center services must have needed services included in
his or her IPP which also identifies who is responsible for payment for the services.
Services generally fall into the following categories: 1) personal care, 2) domestic services,
3) related and other services and, 4) paramedical services. In order to receive all PAS that
is required, services and payment from several different sources, i.e., IHSS, regional
center, private funds, etc., may need to be combined.
Personal care services include:
C Ambulation C Feeding and fluid intake

C Bathing C Assistance with self-administration
C Bowel and bladder care of medications
C Dressing C Menstrual care
C Grooming C Prosthesis care and assistance
C Range of motion and other C Repositioning and skin care
exercises C Respiration
C Transfers
Domestic services include:
C Sweeping, vacuuming, washing and C Taking out garbage

waxing floors C Dusting and picking up
C Washing kitchen counters, sinks, C Changing bed linens
cleaning oven and refrigerator, etc. C Wheelchair cleaning and battery
C Cleaning the bathroom maintenance
C Laundry, including ironing, mending
Related and Other services include:
C Preparation of food C Help to participate in work, home or

C Meal cleanup community activities
C Menu planning C Facilitation at meetings
C Protective supervision C Assistance with use of
C Teaching and demonstration communication devices
C Transportation C Assistance with inclusion in social
C Companionship and recreational activities
C Money management C Assistance with self advocacy
C Shopping activities
(Rev. 2/02) 3
Paramedical services include:
C Administration of medications C Inserting a medical device into a

C Puncturing the skin body orifice, i.e., catheter insertion,
C Activities requiring sterile ostomy irrigation
procedures
C Bowel program
(Rev. 2/02) 4
WHERE does the money come from?

Various combinations of federal, state, local and private funds are used to fund PAS. The
most common resources used by an individual with a developmental disability are listed
here. The regional center and/or supported living services agency help coordinate PAS
regardless of the funding source. Natural supports are another source for PAS that are
generally at no cost or very low cost.
REGIONAL CENTER
The DDS receives funds through several federal programs (i.e, Title XX, Social Security
Block Grant; Home and Community Based Services (HCBS) waiver). These funds, in
addition to state general funds, are distributed to regional centers to provide a wide range
of services to eligible individuals. These services, including PAS, can be purchased only
after all other generic and natural resources are accessed. The regional center provides
for, or helps coordinate services for, those needs listed in the IPP. Those services
identified in the IPP as regional center funded are paid for by the regional center.
IN-HOME SUPPORTIVE SERVICES (IHSS)
IHSS provides assistance to those eligible aged, blind and disabled individuals who are
unable to remain safely in their own homes without this assistance. It is an alternative to
out-of-home care. IHSS is not available for services outside the home except in very limited
circumstances.
Eligibility for IHSS
A person is eligible for IHSS who is a California resident who is living in his or her own
home, and who meets one of the following conditions: [MPP 30-755.1; 30-770.4]
< Currently receives SSI/SSP benefits. (A person who receives the SSI out-of-home
board and care rate does not qualify for IHSS. This is considered to be non-medical
out-of-home care. The SSI board and care rate includes care and supervision for that
individual.) [MPP 30-701(o)(2); 30-763.72)]
< Medically needy aged, blind or disabled. [W & I Code §14132.95]
< Meets all SSI/SSP eligibility criteria, except for income in excess of SSI/SSP eligibility
standards.
< Was once eligible for SSI/SSP benefits, but became ineligible because of engaging
in substantial gainful activity, and meets all of the following conditions:
(Rev. 2/02) 5
- The individual was once determined to be disabled in accordance with Title XVI of
the Social Security Act (SSI/SSP).
- The individual continued to have the physical or mental impairments which were
the basis of the disability determination.
- The individual requires assistance in one or more of the areas specified under the
definition of "severely impaired individual" (see Definitions in the Appendix).
[W & I Code §12305.5]
< Otherwise eligible applicants who are currently institutionalized or in a licensed

residential arrangement, who wish to live in their own homes and who are capable of
safely doing so if IHSS is provided, shall upon application receive IHSS based upon
a needs assessment. [MPP 30-753(o); 30-755; 30-770.4]
Eligibility for IHSS (PCSP) is limited to individuals who:
< Do not receive advance IHSS payment [MPP 30-780.4];

< Receive SSI (are not just SSI eligible);
< Receive IHSS from someone other than a spouse, or from a parent if the recipient is
a minor; [W & I Code §14132.95(f)]
< Need one or more of the kinds of personal care as defined in W & I Code
§14132.95(d)(1)1; and
< Has a disabling condition that causes functional impairment that is expected to last
at least 12 consecutive months, or that is expected to result in death within 12
months, and who would be unable to remain safely in his or her own home if these
services were not provided. [W & I Code §14132.95]
In cases of excess income, eligibility can be established with payment of a share of cost.
MEDICARE HOME HEALTH
1
Welfare and Institutions Code (W & I Code) §14132.95
(d)(1) For purposes of this section, personal care services shall mean all of the following:
(A) Assistance with ambulation.
(B) Bathing, oral hygiene and grooming.
(C) Dressing.
(D) Care and assistance with prosthetic devices.
(E) Bowel, bladder, and menstrual care.
(F) Skin care.
(G) Repositioning, range of motion exercises, and transfers.
(H) Feeding and assurance of adequate fluid intake.
(I) Respiration.
(J) Paramedical services.
(K) Assistance with self-administration of medications.
(2) Ancillary services including meal preparation and cleanup, routine laundry, shopping
for food and other necessities, and domestic services may also be provided as long
as these ancillary services are subordinate to personal care services. Ancillary
services may not be provided separately from the basic personal care services.
(Rev. 2/02) 6
Medicare Home Health provides part-time or intermittent skilled nursing care, home health
aide services and physical or speech therapy. This program is for persons over age 65
who are confined to the home and eligible for Social Security benefits, or those who have
received Social Security Disability benefits for more than 2 years. Contact the Social
Security Administration Office for more information. The telephone number is listed in the
federal government pages of the telephone book.
VETERANS ADMINISTRATION
Veterans and eligible family members may qualify for PAS. Check with the Veterans
Administration or a county veteran’s service office for additional information. Their
telephone numbers are listed in the federal government pages of the telephone book.
PRIVATE FUNDS
Although grants are usually not available for direct personal services, there may be funds
available for special equipment, home modifications, computers, etc., needed by the person
receiving PAS. There are some publications that list grants available. Your local library can
direct you to any information they have. Also watch for announcements for grant
applications in various publications. You can also call various corporate and company
headquarters to see if they offer grants for the type of service or equipment needed. Don't
forget that the telephone company and other utility companies often have special
equipment and/or special rates available for individuals with a disability who use certain
types of equipment at home or for those with a low income.
The regional center is responsible for pursuing all sources of funding for consumers
receiving regional center services. This includes government, insurance and other private
funds that are liable for the cost of services provided. [W & I Code §4659(a)]
(Rev. 2/02) 7
FIRST THINGS FIRST – PLANNING

Let's start putting things together. Who is going to help with hiring? What will the job duties
be? Where do I find someone to do the job? When do I need a new attendant to start
work? What kind of a person am I looking for? What if . . .?
The hiring process begins with a lot of planning, including assessment and evaluation of
your needs. Some things to do or think about are listed below. Those items marked with
an asterisk (*) are usually part of the IPP process and may already be done. Be sure to
include your preferences and non-negotiables in this planning. It will be important
to be up front with applicants about these non-negotiables during recruitment and
selection.
Assessing Support Needs

‚ * List all areas in which you need personal assistance, including personal care, money
management, transportation, companionship, supervision, recreation, school,
community involvement, committee or board membership or meetings, volunteer jobs,
etc.
‚ About how much time will it take to provide all those services and on what days are
services needed?
‚ * How do you communicate? If facilitation is needed, who will do this?
‚ * What kinds of equipment, modifications, etc., are needed for the services to be
delivered safely for you and to protect the assistant from injury?
Preferences
‚ * Will the assistant be required to know CPR, first aid, etc.?
‚ Is experience necessary?
‚ * Do you have a language and/or cultural preference?
‚ Do you want a friendship type of relationship with the personal assistant(s) or only a
professional employee/employer relationship?
‚ What age group and gender are you most comfortable with as a provider of personal
assistance services?
(Rev. 2/02) 8
‚ What are the rules of the house that the personal assistant is expected to abide by?
For example, will the personal assistant be allowed to smoke in the home or around
you?
‚ What will the work rules be? For example, will the personal assistant be required to
call if late? Who should the assistant call?
‚ How much notice will you require when the assistant leaves employment?
‚ Do you want the assistant to sign a work agreement that lists the job duties and other
requirements?
Meeting Support Needs and Preferences
Assistance
‚ * Who is providing personal assistance services now? Will that continue and for
how long?
‚ How many people are needed to provide the services?

‚ * What natural, generic or community resources are available to provide needed
services?
‚ What would be best: come-in assistant, live-in assistant, housemate/roommate or

some combination?
‚ * Who will train new personal assistants? Will you train someone who has no
experience? Will you do the training or have someone else do it?
‚ What will be done about having back-up assistance available?

‚ Who will evaluate whether the assistant is doing a good job or not?
‚ What is the pay? (This is often set by the funding program such as IHSS, regional
center, etc.)
Scheduling
‚ What kind of schedule is best? How much change will you accept in order to
accommodate an assistant's schedule?
‚ Do you need someone who can or will stick to a schedule or someone who can
just go with the flow of the day?
(Rev. 2/02) 9
Transportation
‚ * Will the assistant be expected to provide transportation for you? In your vehicle
or the assistant’s vehicle? Who will pay for the assistant's gas?
‚ What type of insurance is required for any transportation provided? Will proof of
insurance be required?
‚ Is public transportation to the home available or will the assistant need his or her
own transportation?
Other
‚ Is a list of non-verbal methods of communication needed?

‚ Will the personal assistant(s) handle your money, bill paying, etc.? What
safeguards will be used?
‚ Will the personal assistant(s) be given a key to the home?
Health and Safety

‚ * What safeguards are needed to prevent neglect or abuse — fiscal, physical, mental,
etc.?
‚ Is a job description needed? Who will write it?
‚ * If you don't communicate verbally, how will someone outside the home know help
is needed? Who will respond?
‚ * Who, besides the personal assistant(s), will be responsible for checking in to be sure
that everything is working okay?
‚ Will a background or fingerprint check be required to screen for certain types of

criminal convictions?
‚ Will references be required?
‚ Will a Department of Motor Vehicles printout be required to check the assistant’s

driving record?
Living Arrangements (physical/environmental)

‚ If live-in assistance or a roommate will be used, is the home large enough?
‚ How will be rental agreement be handled?
(Rev. 2/02) 10
‚ Which living areas will be shared and which will be private?
‚ Will food be shared or is each person responsible for his or her own supplies?
‚ Will the telephone be shared or will the roommate be required to have his or her own
telephone installed?
‚ How will utilities and rent be shared?
‚ If a live-in attendant or roommate doesn't work out, how will that person be "evicted"
from the home?
Characteristics of a Personal Assistant
What personal traits will a successful assistant need for this job? Look for the following and
add any special characteristics that may be required.
Personal
< Clean and neat.

< On time for the interview.
< Treats you with respect.
< Pleasant/cheerful outlook (you don't need someone who seems down on life).
Professional
< Experience, if required.

< Willingness to do things your way rather than impose their way.
< Can follow strict routine, if needed, or adapt to changes in daily routine.
< Has a commitment to be there when scheduled for work.
< Accepts you as you are rather than wanting to change you.
< Knows first aid and CPR, if required.
(Rev. 2/02) 11
RECRUITING
Now you have a pretty good idea of what you're looking for in an assistant —
superman/woman! And, maybe that is who will apply for the position. But just in case,
have some flexibility in your selection criteria. What is negotiable? What is not? You must
be up front with applicants about the non-negotiables during recruitment and selection.
Decide now who is going to do what during the recruiting process. Do you want or need
help from your supported living services agency, a relative, a friend or other person? Who
will do the screening or help with screening telephone calls from applicants? What
telephone number will be used in advertisements? If possible, you may want to use a
telephone number that is not yours, such as a relative’s number or a business number, if
a business is helping you with recruitment.
Who will help with the face-to-face interview? Where will it be held -- in a neutral place
such as a coffee shop, etc., or in your home? If you are doing criminal records checks,
who will be responsible for this?
HOW ARE YOU GOING TO RECRUIT?
Family and Friends
Many people find their support staff through family, friends and acquaintances. A person
who may already know you and who has similar interests, has a similar cultural background
(or at least a good understanding of it), and who might have a more personal commitment
may be available.
But, you also have to consider the non-negotiables, regardless of who is available. Does
this person meet the needs found during the planning? Can this person provide the
services safely, both for you and him/herself?
Newspapers
Classified advertisements can reach a large number of potential applicants. Will you use
a city-wide or local community paper? Will you use a small classified ad or a larger ad that
can include more information and may get more attention? Is the cost worth the difference
in size? A newspaper can give your ad more exposure, but it can also get lost in the
hundreds of other ads. You need to be sure that whatever paper(s) you choose, it is one
that job seekers are most likely to use.
Colleges, Universities and Vocational Schools
Don't forget that many students have to work to pay their school expenses. List with the
general placement office, but also place flyers on bulletin boards. Be sure to also post
flyers on bulletin boards in the classroom areas for nursing, social sciences, psychiatry,
(Rev. 2/02) 12
psychology and other major subject areas where students may have more of an interest
in working directly with consumers.
Don't forget vocational schools. Some offering short term courses may not produce long
term employees. However, some courses may last a year or longer and you may find
excellent employees. Check with the job placement office.
Community Bulletin Boards
Where are they? Almost everywhere. Check in the grocery store, shopping mall,
Laundromat, church or synagogue, parks and recreation offices, schools and senior
centers. Some businesses and government offices have bulletin boards where you or an
employee of that agency may post notices. While you may not lure someone already
employed away from their job, remember that they also have friends and family looking for
work.
Independent Living Centers
Independent Living Centers (ILC) are nonprofit agencies funded to provide consultation,
training, information and referral on housing, advocacy and accessibility. Many have
advice, materials and/or training available about finding and hiring a personal assistant. Ask
if they have a registry or referral list of persons available to provide personal assistance
services. A list of ILCs is available from the California Foundation of Independent Living
Centers:
Telephone: (916) 325-1690 Internet: www.cfilc.org
County Welfare/Social Services — Adult Services Office
For consumers eligible for IHSS, some county IHSS offices may provide assistance in
finding someone to provide IHSS services. The county usually does not do any
employment screening of people they refer. Be sure to do the same screening for these
referrals as you do for any other applicants. Ask the county IHSS worker or call the office
directly. Check the county government pages of the telephone directory for the number to
call.
WHAT TO INCLUDE IN ADVERTISEMENTS
At a minimum, include a brief description of the duties, hours needed, a telephone number
and the best times to call. However, this will generate calls from people who don’t meet
the “non-negotiable” requirements of the job or who are looking for a higher wage than will
be paid. Unless cost or space is a big issue, it’s best to include the non-negotiables and
wage information. Consider using a telephone number other than your number if help is
needed for screening calls. Do not give an address in the advertisement, unless it is
a business address where someone can drop off an application. There is no need to tell
(Rev. 2/02) 13
the “world” that someone needing personal assistance lives at 123 Pine Street. However,
you might want to include a general location such as North area, Central Park area,
downtown, etc.
Beyond the minimum ad, and depending on the budget, the sky is the limit. Be sure to
include enough information so that those qualified will call and obviously unqualified
persons are discouraged from calling. This may include expanding on the duties, or a little
information about you. Examples would be “loves rock (or classical, etc.) music”, “outgoing
personality would like similar”, “would like companionship to attend XYZ concerts, go to the
beach, etc.” This is the time to be more specific about non-negotiables and preferences,
for example: non-smoker, own transportation required, DMV check will be required, etc.
As your ad gets bigger, think about adding some things that might get more interest. What
do you have to offer? Some things you might have to offer are:
< Meal(s).
< Paid admission to concerts or other activities when accompanying you.
< Paid public transportation or help with gas money.
< Flexible schedule for students, parent with school age children, etc.
< For live-ins:
< Location, i.e., near school, transportation, quiet neighborhood, or other
community amenities.
< Private room and bath.
Obviously, the standard job benefits of insurance, paid vacation, etc., are few and far
between — and may be set by the program funding the services. There are some things
that can make a difference but be sure the funding program doesn’t prohibit whatever
you’re thinking of offering.
Be careful about providing too much personal information during this step. Remember that
this advertisement is only a first step in hiring. As telephone screening and personal
interviews take place you may need to give more information, but you can decide after
talking to the applicant whether to do this.
Don’t limit yourself to one type of advertisement. What is used for a classified ad may be
very different from a bulletin board flyer.
TELEPHONE SCREENING
This is the first interview for applicants. You are under no obligation to do a face-to-face
interview with everyone who calls. If you want help with the telephone screening, ask a
relative, friend, the supported living agency or your regional center case manager for help.
Use this time to screen out those who obviously don’t meet the qualifications and to set up
interviews for the more likely applicants. Again, do not give an address or personal
information unless you are going to schedule a face-to-face interview. Then give only the
minimum information needed so the caller can decide whether to interview and so he or
she can get to the interview location.
(Rev. 2/02) 14
Have a list of questions to ask. You may want to photocopy the list and keep a separate
page for each applicant with your comments. Ask the same type of questions of every
applicant so you can do a fair comparison. Following are areas you want to be sure to
cover in the telephone screening.
Job Description
Briefly describe the job: This job includes housecleaning, laundry, help with shopping, meal
preparation, feeding and personal care, including bathing and toileting, etc.
< Do you have experience in doing this type of work?

< Have you done personal care services before? How do you feel about doing this?
< What kind of experience do you have and for how long?
< If you will hire and train inexperienced persons: Are you willing to learn to do these
things?
< Is there anything I’ve described that you cannot do or will not do?
Schedule
Describe the schedule(s) the personal assistant is expected to work. Include both the hours
and the days, i.e., Tuesday through Saturday, 6:00 a.m. to 9:00 a.m. and 4:00 p.m. to 8:00
p.m.; or Sunday through Wednesday overnight from 9:00 p.m. to 6:00 a.m.
< Is there anything that would keep you from being able to work this schedule?
< If you are hiring for several different schedules: Do you prefer one of these schedules
over another?
Non-negotiables
“I’m looking for someone who is . . .” (describe any non-negotiables, i.e., nonsmoker,
language requirement, etc.)
< Do you meet these requirements?
Conviction of Crime
Any information you receive about a person's criminal history is confidential. You
and anyone helping you with the interviewing and hiring of an employee must be
very careful in what is asked and how any information relating to conviction of a
crime is used.
Questions may not be asked about arrests or charges filed without a conviction.
Questions may be asked about criminal convictions. Conviction of a crime doesn't have to
automatically exclude someone. Decide during the planning process how “yes”
answerswill be handled. See the following section, The Interview, for additional
information. See page 20 for information about doing a fingerprint check on applicants.
(Rev. 2/02) 15
Do not: ask about arrests. Don't ask "Have you ever been arrested (or charged) for a
crime?" Asking about arrests or charges for which there is not a conviction is a
misdemeanor. An applicant asked these questions may also file a complaint
with local law enforcement agencies, the Labor Commissioner and bring civil
action against the employer.
Do not: ask if the applicant was ever referred to or participated in diversion programs
(drug, alcohol, etc.).
Do not: share the fingerprints or any criminal information received from the applicant or
the Department of Justice with any other employer or person. This information
may be used only by you and the person(s) or agency helping you with the hiring
process.
The right question to ask is: "Have you ever been convicted of a crime?"
A person who pleads guilty, is found guilty by a jury, is found guilty by a judge in a non-jury
case, or enters a plea of nolo contendere (no contest) is considered to be convicted of a
crime. A plea of nolo contendere (no contest) is automatically treated as a conviction.
Ask some questions about criminal convictions. If true, tell the applicant that a “yes” answer
may not automatically mean that he or she won't be hired, but more information may be
required if scheduled for an interview.
< Have you ever been convicted of any crime or entered a plea of nolo contendere related
to:
< assault, battery, abuse, injury or death of another person?

< theft, burglary or robbery?
< money, such as embezzlement, credit card misuse or misuse of someone else’s
money?
< alcohol or illegal use of drugs?

< Are you on probation or parole now for conviction of any crime or for a plea of nolo
contendere?
< If the answer to any of these questions is “yes,” ask:

< What was the conviction (or plea of nolo contendere) for?
(Rev. 2/02) 16
< How long ago was the conviction or the plea of nolo contendere? (If it has been many
years with no recent convictions it might be viewed differently than a more recent
conviction.) Note: A criminal history check done through the Department of Justice
gives conviction information for the past ten years.
< If you served time in jail or prison or were on probation or parole, when did that end?
What decisions were made during planning about a “yes” answer to questions about
conviction of a crime? Based on the answers to these questions and other qualifications,
will this applicant be scheduled for an interview?
Other Questions
Ask any other questions that you feel are important enough to help decide whether to
schedule an interview with this applicant.
Scheduling the Interview
If an interview will be scheduled with this applicant you might want to ask the following:
< Interviews are being scheduled for several applicants. Now that you know a little more
about the job, are you still interested?
< Can you come on (day, date and time)? or
< Interviews will be on (days and dates). Is there a day or time that is most convenient for
you?
This is the time to request the applicant to bring any additional information to the interview
such as a list of references with telephone numbers, a DMV driver’s license printout, etc.
Be sure to give the applicant directions for getting to the interview. You may want to have
the first interview at a neutral location such as a coffee shop or other meeting place, at the
supported living agency office, etc., so be sure you have the correct address and directions
for that place. Also give the telephone number and ask for a call if he or she has a change
of mind or for some reason can’t get there.
Thank the applicant for calling and reconfirm the day, date and time of the interview.
< Thanks for calling. I’ll see you on Thursday, the 25th at 9:00.
No Interview
For someone who is not being scheduled but that you may want to call back if other
interviews don’t work out:
< Thank you for calling. May I please have your telephone number so I can get back to
you to either schedule an interview or let you know if the job has been filled.
(Rev. 2/02) 17
THE INTERVIEW
Plan the interview before the applicant comes. It is usually a good idea to plan to have a
friend, family member, supported living services agency employee or other person there
to help you feel more safe and comfortable and to help interview if you want help.
When the applicant arrives, try to make him or her feel comfortable and welcome. Introduce
everyone present. Watch how the applicant acts toward you.
There are an almost endless number of questions that can be asked during the interview.
Following are some sample questions. Be sure to also look in the Appendix for other
sample questions.
You may want the applicant to complete a written application before starting the interview.
Answers to the questions on the application may save some time in the interview. The
answers may also help you decide if you need to ask additional questions. Also, it is
important to have a record of the interview and the answers to important questions,
especially about convictions. The written application may also help later if you must
dismiss an assistant because he or she did not tell the truth and cannot do the job.
Job Description
Start the interview with a further description of the job. It often helps to have a detailed
written description for the applicant to read. There are examples of these in the Appendix.
Be sure to describe any physical work such as transfers, helping in and out of a car, jobs
requiring bending, stooping and lifting (how much weight, etc.). Especially if the applicant
doesn’t have much or any experience with the type of assistance needed, it may be wise
to describe more fully what is involved with some of the procedures.
Also explain who is the boss, e.g., who gives the orders, who the assistant reports to, etc.
< Does this still sound like a job you are interested in doing? (If the answer is no, thank
the person and end the interview.)
< Is there anything about the job that you do not want to do or will not do? (If the answer
is yes, ask more questions to determine if this will really affect the applicant’s ability to
do the job. If it will, thank the person and end the interview.)
< During the telephone interview you said you have experience in doing this type of work.
Please tell me more about your experience and how you can use it in this job.
< Is there anything described in the job where you do not have experience or will need
more training to do the job? or
(Rev. 2/02) 18
< During the telephone interview you said you do not have experience in doing this type
of work. Tell me more about you and what skills or other experience will help you to do
this job well.
Reconfirm the Schedule
Although the schedule was discussed during the telephone interview, take time to reconfirm
the days and hours the applicant would be required to work. Or, if there are several
schedules or a flexible schedule available, discuss which one the applicant would prefer.
Even when the applicant has a preference, ask if he or she is willing to work any of the
other schedules in case the preferred time isn’t available.
Reconfirm the Non-negotiables
Not meeting a non-negotiable will most likely lead to a failure of the relationship with an
attendant. Since this is so important it’s best to confirm again that the applicant does meet
all the non-negotiables. If an otherwise good applicant doesn’t meet the requirements, take
a few minutes to discuss it and see if he or she is willing to make a compromise that will
be satisfactory.
Reconfirm Conviction of a Crime Question
Review the Conviction of Crime section on page 16.
< On the phone you said you have never been convicted of a crime, is that correct? (If
the applicant confirms that there have been no convictions, skip to More Questions
section.)
If an applicant with a conviction is scheduled for an interview, this is the time to get enough
information to make a decision on whether that conviction will make a difference in whether
or not you would hire him or her. Remember, you are not retrying the case to determine
guilt or innocence — that has already been done in court. Ask only the questions that you
need in order to get enough information for a decision to hire or not hire. Here are some
sample questions:
< On the phone you said that you have been convicted of (or you entered a plea of nolo
contendere for) (assault, embezzlement, etc.), is that correct?
< Are there any other convictions, including any plea of nolo contendere?
< How long ago was the conviction or plea of nolo contendere?
< Did you serve jail or prison time? How long?
< Did you serve probation or parole time? How long? What was the probation/parole
officer’s name?
< Are you on probation or parole now?
< If I call the probation/parole officer about you, what will he or she say about you and
your ability to do this job?
< Please tell me briefly what happened.
< Please tell me what you have done to assure that it won’t happen again and that I would
be safe with you as my attendant.
(Rev. 2/02) 19
< If I decide to hire you, are you willing to let me do a criminal records check on you?
(Any criminal records check done will usually include only California convictions.)
If the applicant looks like a good possibility:

< If you are doing a criminal records check for applicants you intend to hire, tell him or her
that you will need to have a fingerprint card completed in order to do a criminal record
check. Do this only for anyone you intend to hire — not just someone who has told you
of a conviction. Do not do a criminal records check for anyone that you have already
decided not to hire.
< Do the criminal records check.
If there is a conviction and you may hire the applicant:

< Contact the parole or probation officer for a reference, if possible. Get the officer’s
name, telephone number and the office address.
< Discuss the general situation with a few other trusted people to get their opinions. (Do
not violate the privacy of the applicant by disclosing a name or other information that
may identify him or her.)
< Be safe, not sorry. Be sure this is what is the best and safest situation for you before
making any commitment.
Criminal Record Check
A criminal record check may be done according to a provision in law that allows the
California Department of Justice (DOJ) to do this check if both of these conditions are met:
1. The employer requests the determination and submits fingerprints to the DOJ.
2. The person is unlicenced and provides nonmedical domestic or personal care to an
aged or disabled adult in the adult’s own home.
The DOJ will check for convictions within the past 10 years for the following:
< Sex offense against a minor.
< Violation of Section 243.4 (sexual battery); 273a (child endangerment); 273d (child
abuse); 368(a) or 368(b) (elder and dependent adult endangerment/abuse) of the Penal
Code.
< Theft, robbery, burglary.
< Any felony.
The criminal records check will include convictions in California and out-of-state convictions
that are reported to California Department of Justice. Many out-of-state convictions are not
reported to California. Convictions for crimes that occur before age 18 are usually sealed
and are not reported. Within 30 days of receiving the fingerprint card, the DOJ will notify
the employer whether or not they found convictions of any of the above crimes or if more
information is needed.
The DOJ calls this type of fingerprint check "Elder Care Certification." Their guidelines and
cost for fingerprint card submissions are in the Appendix. Fingerprint cards are available
from the DOJ by calling them at (916) 227-3834. Fingerprint cards are also available from
your local police or sheriff's department and they may also take the fingerprints for an
applicant. Some private businesses also provide fingerprinting service — check
"fingerprinting" in the yellow pages of your telephone directory.
(Rev. 2/02) 20
More Questions
< Do you have any physical, mental or other limitations that would prevent you from doing
this job?
(This may be one of the most important questions to ask. Asking this question gives
the applicant a chance to do a self-evaluation. Just be sure that the job description is
accurate. If the applicant says that there are no restrictions and you find that he or she
can't do the job because of one of these reasons, you have a reason for dismissal.)
< If you are asked to do something differently than you’ve done in past jobs, how would
you handle it? What if you think your way is better? (Describe a specific situation and
ask how the applicant would handle it.)
< I really need someone I can count on to be here every day and be on time.
< Have there been times when you were scheduled to work but were not able to show
up or had to be late? Why couldn't you be there?
< How did you let your boss know you wouldn't be there?
< Have you ever quit a job without giving notice to your boss? What happened to
make you quit?
< If I like things that you don’t like, can you accept this without trying to change me? (This
could include smoking, drinking, religion, music, entertainment activities, neatness or
clutter in home, etc.)
< Do you have dependable transportation to get to work?
< How will you notify me if you can't come to work? Do you have a telephone?
If the applicant claims fluency in a language that is needed for the job, conduct the
interview in that language, if possible, to be sure about the level of fluency.
Housemate Questions
If the personal assistant will also be a housemate, follow the same steps as when hiring
an attendant but also consider:
< Could I live with this person being around all the time — not just when he or she is on
duty. Remember, your home may be his or her only home.
< Am I willing to share my home with my housemate’s friends and family?
< Would I expect the roommate to provide services even when "off duty" just because he
or she is there? How would this person react to that request?
< Will we or how will we share: Rent? Food? Utilities? Telephone? The best chair
in the house? The bathroom?
(Rev. 2/02) 21
< Will this person keep his or her areas of the house clean and neat enough for me?
< Or, my areas are usually pretty cluttered and I like it that way. Can this person live with
my habits?
< I like rap music turned up loud. Does this person like rap or can we at least tolerate
each others music and volume?
Pay and Benefits
Discuss the rate of pay. Let the applicant know when payday is and how they will be paid.
Is a time sheet required? Who will sign-off (verify) the hours worked?
If In-Home Supportive Services (IHSS) is paying for the services, explain that the rate of
pay is set by law. IHSS is generally paid by a check from the state and requires a time
sheet to be sent to the county twice a month.
Discuss any benefits. Most personal assistant jobs do not have benefits such as
insurance, paid sick leave and paid vacation. If this is the case for this job, be sure the
applicant knows this. IHSS providers are eligible for unemployment insurance (if not the
parent or spouse), workers' compensation and state disability insurance. In addition, IHSS
deducts for social security and medicare taxes. IHSS does not deduct for income taxes
unless the personal assistant asks them to do this.
Payments from sources other than IHSS may be subject to various employer and employee
taxes. If you are not sure about other funding sources, ask them if they handle payroll
taxes and other deductions. If they don’t, check with your local Employment Tax District
Office. The telephone number is in the State Government pages of the telephone directory.
Questions NOT to Ask
There are questions that should not be asked and that may be considered discriminatory
or otherwise not appropriate. All questions must be relevant to the performance of the job.
Asking the question, "Do you have any physical, mental or other limitations that would
prevent you from doing this job?" gives the applicant a chance to do a self-evaluation. Just
be sure that the job description is accurate. If the applicant says that he or she can do the
job, then age, children, marital status, etc., should not be a consideration. If later, any of
these things interfere with job performance, that may be a reason for dismissal.
Some questions NOT to ask during an interview include:
< How old are you?

< Are you married?
< Do you have children?
< How much do you weigh?
< Do you have a bad back?
< Have you ever been arrested? (Only questions about convictions may be asked.
Remember that a person is considered innocent until proven guilty.)
Decision Time!
(Rev. 2/02) 22
If the applicant is qualified and is definitely being considered for hire, let him or her know
that you will be checking references (and criminal records, if applicable). Ask when he or
she is available to start work if selected for the job. Let them know that you will contact
them to let them know your final decision.
Don't take too long to make a decision when you have good applicants. The good ones are
probably interviewing for other jobs also and may be hired by someone else before you call.
Hiring
First, call the person you choose to hire with the good news. Make sure that you have a
firm commitment from him or her. Be clear about what schedule the person is to work,
especially if there is more than one schedule. Set the date and time for the first day of
work.
Then call the other applicants or send them a letter. Tell the applicant that you have made
a decision to hire another person. Thank them for interviewing with you. If backup or
on-call help is needed, and you liked the applicant, ask if he or she is willing to do that.
Also ask if you can keep their name on file in case you need to hire again soon.
(Rev. 2/02) 23
THE FIRST DAY

Have the new assistant sign all paperwork. This may be the job description or duty
statement to show that he or she knows the duties. If it is an IHSS worker, a provider form
must be completed for the county. There may be other payroll documents that need to be
signed.
TRAINING
Proper training is so important. This is also the time to educate the assistant if he or she
is not familiar with working for a person with a developmental disability. Teach him or her
to listen to and to honor your choices and directions. Teach them how to communicate and
understand you if communication is difficult.
Don't just show the assistant how to do something. Take the time to explain why it's done
that way. Otherwise something that seems minor to the assistant but that is very important
to your comfort or safety may be skipped. Follow the job description as you show him or
her what needs to be done. This way you will be sure everything is covered.
Don't expect the assistant to read your mind! Trying to always guess what someone wants
is very stressful. It's also stressful for you to not receive help because the assistant did not
guess right or at the right time.
Think about making checklists for the assistant. List those things that need to be done
including the time they are to be done, if the time is important. Always make a list for any
medication schedule. This may be a check-off list so you and the assistant know the
medication was given as scheduled.
Cover emergency procedures. List important telephone numbers, not only for emergency
services, but for other people to call, such as the supported living services agency or
regional center.
Tell the assistant how you will let him or her know when things are going right or wrong.
(Rev. 2/02) 24
ABOUT TRUST
We all like to think that anyone we hire can be trusted. In most cases that is true. But, you
can't always tell by looks, references or even actions. This is why businesses have "checks
and balances" whenever employees have access to money or other valuables. Businesses
that are careful do not allow just one employee to deposit money, write checks and balance
the checkbook. This is not because they don't trust every employee, but, if there is a
problem, they will find out about it more quickly.
You should also have "checks and balances" with personal finances and possessions.
Here are some things to think about.
Personal Finances
< Have a checking and/or savings account.

< Use direct deposit whenever possible.
< Limit the number of people who have access to the account.
< Do not keep a lot of cash on hand.
< Be careful about who has access to the account with an ATM number. Most banks will
change the number upon request. Consider changing it whenever anyone who has the
number is no longer employed by you.
< If possible, get your own mail from the mailbox and look at it right away. This way you
will see everything that is coming in and will know if there are extra bills or notices that
bills haven't been paid.
< Get the checkbook balanced as soon as the bank statement comes. Do not have the
same person who makes deposits or writes checks help balance the checkbook.
< Check all bills for unauthorized charges. This not only includes any credit cards but
also the telephone, cable and other utility bills.
< Require a receipt for any cash spent by an assistant.
Personal Possessions
< Use a safe deposit box for valuables including personal papers, birth certificate, etc.
< Make a list of all valuable belongings such as stereo equipment, lifts, etc. Include the
serial number, if any.
< Take a picture of valuables including any special equipment you use. Keep the pictures
somewhere safe such as in a safe deposit box.
< Keep track of all keys to the home and any vehicles. Make a list with each person's
name who has keys.
< Consider changing locks or having them retooled when any employee who had a key
leaves even if they give you a key back. Retooling is done by a locksmith. The same
lock is used but it will be changed to a different key.
Being an employer is much like being in business, even if you have only one employee.
By taking these precautions, you are doing what any good business does, even with its
most trusted employees.
(Rev. 2/02) 25
COMMUNICATION
There are hundreds of books on the art of communication. In addition to other sources,
some supported living services, independent living providers and advocacy groups provide
training in communication. There are also some tips in the Appendix. Instead of repeating
others, here are just a few things to remember.
Good communication with an assistant means that you are able to let him or her know how
you feel, what you need, when you want something done and how you want it done. It
means telling that person that the job is done well or that it needs to be improved.
Remember, you didn't hire a mind reader!
However, communication must work both ways. Not only communication from you to the
assistant, but from the assistant to you. You also need to listen and be aware of what the
assistant is telling you.
How you say it is just as important as what is said. Certain tones of voice or certain actions
may keep a person from hearing what you are saying. They may be listening to how it is
being said instead of what is being said.
(Rev. 2/02) 26
HOW TO DISMISS AN ASSISTANT

Sometimes things just don't work out. Sometimes both you and the assistant will agree that
it is best for him or her to leave. Sometimes it may be just you who decides that a change
is needed. Either way, this is usually one job that no one likes to do.
If things aren't going well, talk it over with someone you trust. Is it a problem with
communication? Does the assistant know what is expected? Does he or she need more
training? Are you expecting more than is in the job description? Or is it something that you
feel can't be fixed? Be sure you are being reasonable.
Once the decision is made that you do not want this person working for you any more, let
him or her know. You may feel safer if someone else is with you at this time. You do not
have to go into great detail about your reasons. Be sure to give proper notice to your
assistant just as you would expect notice if he or she were to quit.
If the reason(s) for dismissal include injury, abuse, theft, misuse of money, etc., you should
have the assistant leave immediately instead of giving advance notice. It is especially
important to have someone else with you at these times. If you plan to fire someone
without giving notice, plan ahead. You may want to change locks, ATM numbers, etc.,
before you do it.
Don't forget to ask for your key or anything else the assistant may have of yours.
HOW TO HIRE A NEW ASSISTANT
Is there anyone you interviewed that was a good applicant but you did not hire? Check to
see if that person is still available and willing to take the job. Is there part-time or other staff
who might want to add hours or change the work schedule?
If no one is available, then: Go back to page 8 and start over again!
(Rev. 2/02) 27
TABLE OF CONTENTS
APPENDIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Ad For Housemate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2

A
Flyer For Housemate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Guidelines For Accessing & Utilizing

Attendant Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4
P
Job Description for Attendant . . . . . . . . . . . . . . . . . . . . . . . . . A-19
Instructions for Howard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-25

P
E
Sample Job Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-29
Guidelines for Fingerprint Card Submission . . . . . . . . . . . . . . A-31
Emergency Preparedness Checklist for People with Disabilities . A-33
Disaster Preparedness for People with Disabilities . . . . . . . . . A-35
Resource Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-39

N
D
I
X
(Rev. 2/02) A-1

Here's a sample ad used to recruit a housemate.
Housemates Wanted
I'm looking for two people to share my home in the Granada Hills area. I prefer
non-smokers who enjoy sports and/or music (classical, soft rock), male or female.
You will have own room, share kitchen, laundry room, etc. Receive salary plus
rent discount in exchange for assisting me to live in my own home, to go places
and meet people/make friends. The house will be available
(date) .
I am a 33 year old man who works 5 days a week, loves sports (swimming,
tennis, hiking, horseback riding), plays classical piano, likes going to concerts,
movies, etc. I need help to get around town, cook meals, clean house, express
myself, go shopping, etc., because of my developmental disability. I want to
share my home with you if this sounds like something you would be interested in.
Please leave a message with .
Thanks to CHOICESS, 135 E. Live Oak Ave., Suite #104, Arcadia, CA 91106, for sharing this
ad.
(Rev. 2/02) A-2

Guidelines For
Accessing & Utilizing
Attendant Services
Reprinted with permission from Toward Maximum Independence, 9370 Sky Park Court, Suite
250, San Diego, CA 92123.
(Rev. 2/02) A-4

ADVERTISING FOR AN ATTENDANT

Be creative and imaginative as you can in selecting where and how to advertise. Ask
others who have done this what has worked for them. This is a very individual thing and
will depend on your specific needs and the resources in your community.
Places to Advertise
! Local newspaper, weekly advertiser, etc.
! Financial Aid Office (i.e., community colleges, etc.)
! Bulletin Boards (i.e., apartments, grocery stores, libraries, etc.)
! Word of mouth
! Social Service Agencies/Church Newsletter
Sample Ads
Full-time personal care attendant needed for female with a disability. Assist with
personal care, grocery shopping, housekeeping, etc. Minimum wage, hours vary. Ideal
for student. Call___________________.
Part-time personal care attendant needed for male. Eight to twelve noon weekdays.
$4.25 per hour. Call_____________________.
TELEPHONE SCREENING
1) It is important when talking on the phone to be friendly and pleasant.1
2) Give a brief description of what the job is, the pay and the hours.
3) Ask if this is the type of position the person is looking for or interested in.
4) If the person is not interested, thank them for their inquiry and hang up.
5) If the person is interested, set up a time to meet and conduct a formal, personal
interview. Be sure and get the person's name and phone number in case you need
to reschedule. For safety reasons, it is highly suggested you have someone you
can trust present at the formal interview, perhaps a parent, friend, case manager,
etc.
1
Suggestion: Limit information about yourself over the phone — maybe have
it written down so that you can share it during the personal
interview.
(Rev. 2/02) A-5

INTERVIEWING A PROSPECTIVE ATTENDANT 2
1. Try to make your prospective attendant feel comfortable. (Invite them to sit
down, offer them a drink, etc.)
2. Ask the prospective attendant about past jobs they have had. (Look at
application)
3. Ask them if he/she has worked for a person with a disability before.
4. Explain your disability if you feel comfortable.
5. Give job description or IHSS contract for him/her to read.
6. If this is a job the person is interested in, you might want them to fill out an
application.
7. After the person is finished, you may want to ask these questions. Do you feel
uncomfortable about performing any of these duties and responsibilities? Do you
have any questions? Let them know you will train if necessary.
8. Ask any other questions that may be specific to this position.
9. Ask when she/he is available to start.
! Let the person know you will be checking his/her references and will call
them after you have made a decision.
! Thank the person for coming by and escort to the door.
! At this point, while it is still fresh in your mind, it is wise to list what you liked
and disliked about the prospective attendant.
2
Be sure and have someone you trust at this interview.
(Rev. 2/02) A-6

Attendant Application
Part A -
Name:________________________________________________________________
Phone No: Home ______________________ / Work __________________________
Address: ____________________________________________________________
____________________________________________________________
____________________________________________________________
Contact in case of emergency:_____________________________________________
Emergency Phone No: ___________________________________________________
Part B -
1. Are you looking for a Come-in _____ or Live-in _____ position?
2. Dates available for hire:_____________________________________________
3. Are you looking for a Permanent _____ or Temporary _____ position?
4. What hours and days are you available to work?_________________________
5. Do you have another job? __________ / Are you a student? _______________
6. What is your schedule? ______________________ How flexible can you be?
________________________________________________________________
7. Are you willing to do emergency attendant work? _________________________
Part C -
1. What is your means of transportation?_________________________________
2. Do you have a valid California driver's license?___________________________
3. Are you willing to run errands?________________________________________
4. Are you willing to drive me to the doctor?______________________________
Part D -
1. How did you hear about this job?______________________________________
2. Who referred you?_________________________________________________
3. Are there any jobs that you would not want to do? (ex: driving, asst. doctor
appts. or any other jobs included on the job description, etc.)
(Rev. 2/02) A-7

Work Record
Part E -
List most recent employer first:
1. Employer:______________________________________________________
Address:_______________________________________________________
_______________________________________________________
What type of work:_______________________________________________
Dates of Employment: From ___________________ / To________________
Reason for leaving: ______________________________________________
2. Employer:______________________________________________________
Address:______________________________________________________
______________________________________________________
What type of work:_________________________________________________
Dates of Employment: From ___________________ / To__________________
Reason for leaving: ________________________________________________
May I contact current employer?
Part F -
List two other references (other than family):
Name Address Phone Relationship

_____________________________________________________________________
_____________________________________________________________________
(Rev. 2/02) A-8

TELEPHONE REFERENCE CHECK 3
(Sample)
_________________ has recently applied to be my attendant. ___________________

has put you down as a reference. Would you mind telling me about ______________?
All this information will be kept completely confidential. The job is not a high paying one
but there is a lot of responsibility that comes with the position. _________________ will
be assisting me with personal and domestic tasks.
How long have you known ________________________________?

Are you related to _______________________________________?
How long did ________________________________ work for you?
Why did __________________________________________ leave?
Would you rehire _______________________________________?
Why?_________________________________________________
Is ___________________________ punctual?
Is ___________________________ reliable?
Is ___________________________ trustworthy?
Does _________________ tell you when commitments can't be met?
Would you recommend __________________________ for this job?
Thank you for your time, Good-Bye.
3
Be prepared that some of this information may not be legally shared.
(Rev. 2/02) A-9

Applicant Profile
You can use this form to review the qualifications of an attendant or roommate.
Name: ___________________________________ Male “ Female “

Experience: References: (Professional)
1. _____________________________ __________________________________
2. _____________________________ __________________________________
3. _____________________________ __________________________________
Characteristics: Comments:
_____ Friendly __________________________________
_____ Open __________________________________
_____ Asked good questions __________________________________
_____ Confident __________________________________
_____ Used respectful language __________________________________
_____ Gave impression that commitment
was critical __________________________________
_____ Nicely dressed __________________________________
_____ Interested in focus person __________________________________
_____ Comfortable with philosophy __________________________________
Personal References:
Name Relationship Phone
1.____________________________________________________________________
2.____________________________________________________________________
3.____________________________________________________________________
(Rev. 2/02) A-10

Applicant Profile - Continued
Skills:
_____ CPR
_____ First Aid
_____ OT/PT Training
Comments:
Personal:
_____ Pet(s)
_____ Children
_____ Smokes
_____ Willing to assist with personal care/IHSS
Comments:
Reason for Desiring Roommate/Neighbor Position:
On File:
_____ Fingerprints
_____ DMV Printout
_____ Professional References
_____ Personal References
(Rev. 2/02) A-11

Important Things To Know About Me

Name: _______________________________________________________
(This is information that you will want to share with an attendant or roommate that you're
thinking of hiring. Do not share anything you do not wish to share. Consider ways
people can be most helpful yet respectful of your rights and privacy.)
A. Routines (Consider daily needs related to getting up in the AM, preparing for
work, personal care, mealtimes, etc.)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
___________________________________________________________
B. Complex/Medical Needs (Think about specific assistance you will require with
such things as medication, equipment, lifting, transferring, etc.)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________
(Rev. 2/02) A-12

C. Interests, Hobbies, Preferences (What do you like to do? Where do you like to
go? Favorite foods. Pet Peeves. Allergies, etc.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
____________________________________________________________
D. Other (Consider any other important things someone might need to know about
you.)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
____________________________________________________________
This allows a person to share valuable information about themselves in a way which
suits them as opposed to sending them off to read "collateral." It gives the prospective
or new roommate/neighbor or support worker an idea of what is/will be expected of
them. It is kept in the apartment book.
(Rev. 2/02) A-13

What Services You Need and When You Need Them

SERVICES WHEN OTHER INFORMATION
Domestic Services:
Related Services:
C Prepare meals
C Meal clean-up
C Laundry
C Shopping for food
C Other shopping errands
Non-Medical Personal Services:

C Respiration Assistance
C Bowel, bladder care
C Eating
C Routine bed baths
C Dressing
C Menstrual Care
C Ambulation
C Move in/out of bed
C Bathe, oral hygiene/grooming
C Rub Skin, repositioning, help
on/off seats, in/out vehicle
C Care/assistance with prosthesis
Transportation Services:
C Medical Appointment
C To alternate resources
Protective Supervision:
Teaching/Demonstration:
Paramedical Services:
Total Monthly Hours:
Basic Schedule
(Rev. 2/02) A-14

HIRING
Now it is time to make a decision.
1. Call the person you have chosen to tell her/him the good news. Also, be
prepared to give a start date.
2. Call the other applicants saying you have hired someone else for the job. Then
ask if for some chance the position reopens if you could call them back.
- OR -
Ask them if they are willing to work relief when necessary.
TRAINING
It is best to have a former attendant assist with training if possible, or someone who
knows what you need and how to do it.
1. Explain your disability and challenges.
2. Explain any technical words that you use.
3. Be sure to emphasize anything relating to safety or emergencies.
4. When giving instructions involving a procedure - include each step and why it's
important that it be done a certain way.
5. Don't take for granted they know what you meant; ask for feedback.
6. Be patient - your new attendant will probably not get everything right the first
time.
HINTS:
It may be helpful to have technical words, procedures, etc., written out or taped on a
cassette.
(Rev. 2/02) A-15

COMMUNICATING WITH YOUR ATTENDANT OR

HOW TO BE A "GOOD BOSS"
Note: Throughout this guide you will find a strong emphasis on communication.
Learning good communication skills and using those skills are the keys to
working effectively with an attendant.
Good Work Environment
It is a fact that attendant work is usually not well paid and offers few, if any, fringe
benefits. Therefore, those who take this kind of job often do it because it has other
rewards, such as personal satisfaction or a chance to work closely with other people.
That makes the work environment a most important factor in keeping your attendant.
Good employers create a work environment that will bring out the best an attendant has
to offer. You will want your attendant to have good morale, be happy and satisfied with
his/her work and therefore, be a productive employee. Good communication between
you and your attendant can help do this.
To create that good work environment:
1. Reward attendants for the work they are doing. Besides paying them, it is
important to praise them frequently as well. Everyone wants to feel appreciated,
needed and important.
For example, your attendant has transferred you very smoothly from your bed to
your wheelchair. You might say, "That was a really smooth transfer. You do it
very well and I feel very safe." You will have communicated your appreciation in
a very concrete way and your attendant will know that he/she has performed this
task well.
2. When you must criticize something your attendant has or has not done, it is
important to be open and honest and to criticize the action, not the person. For
example, your attendant has returned an hour later than planned. He/she did not
call to explain and you are angry. You might say, "You said you would be home
an hour ago. I feel frustrated and angry when people are late. In the future, I
would appreciate it if you would call me and let me know you'll be late." Don't
say, "You stupid idiot -- you're always late! I don't know what I'm going to do with
you." This will only make your attendant defensive and angry and won't resolve
anything.
(Rev. 2/02) A-16

3. Don't let small irritations build up until an angry explosion occurs. Anger vented
in these explosions often is expressed in a hurtful and destructive way. If you
feel irritated about something that is happening, talk about it as soon as possible.
This may happen daily, especially if you have just begun to work together.
4. Respect your attendants. They are human beings and should be treated
accordingly. Use the Golden Rule and treat your employee as you would like to
be treated. Be honest, fair, kind, respectful and patient.
5. Attendants have their own lives too. Especially with people who live-in, it is
important to be sure to respect their privacy, leave them alone during their time
off and realize that unexpected events sometimes disrupt schedules. Although
your attendant has responsibilities to you, you should not attempt to control
his/her life. Flexibility and compromise are important qualities for both of you.
6. Ask your attendant how he/she feels about their work and about you as an
employer. Set a regular time to share feelings about your relationship. And then,
both of you be open to making changes in the routine, in attitude or in anything
else that can correct a problem. After all, you are not in a nursing home where
routines are set -- this is your home where changes can and should be made.
7. When things just don't work out even after repeated attempts, it is time to
terminate the agreement. There are good and poor ways to do this as well.
Do state your reasons clearly without attacking him/her personally.
Do give a period of notice, usually two weeks. This allows time for him/her to find
a new job and/or place to live and you to find a replacement.
Do not withhold payment of wages even if you are not satisfied with his/her work.
Just give notice and terminate the agreement.
To summarize, you as the employer, have the opportunity to provide a positive work
environment for your attendant. This in turn helps him/her to be happy, productive and
motivated to work for you. Good communication between the two of you is the key to
this interdependent relationship. An attendant who is happy in his/her work will stay
with you longer and do a better job, which will benefit both of you. If you are interested
in learning more about communication skills, check with your local social services
organization, colleges, universities or technical schools for classes in assertiveness,
conflict management or basic communication skills.
(Rev. 2/02) A-17

GIVING PRAISE
1. Always be sincere. Don't say something you don't really mean.
2. Give compliments often.
TWO STEPS FOR GIVING COMPLIMENTS
Step 1: Describe the situation or event which you liked.
Step 2: Tell what your feeling was when it happened.
or
Say that you appreciated it
or
Say "Thank you"
GIVING CRITICISM
1. Give the criticism as soon as possible after the situation that you dislike occurs.
2. Criticize only one incident at a time.
3. Do not bring up things from the past. Stick to the present.
4. Criticize the person's actions; not the person.
5. Keep the criticism brief and to the point.
USE CRITICISM AS A TOOL FOR SHARING INFORMATION WITH YOUR

ATTENDANT THAT WILL HELP HIM/HER TO WORK WITH YOU MORE
EFFECTIVELY. THREE STEPS FOR GIVING CRITICISM:
STEP 1: Describe the situation or event that you disliked.
STEP 2: Tell what your feeling was when it happened.
STEP 3: State what would make it better next time. Give a suggestion.
WORK TOGETHER TOWARDS A SOLUTION.
(Rev. 2/02) A-18

EMPLOYER: George P. DATE:
SALARY:
Work Responsibilities Include:

All my personal care, home maintenance, and errands including all the duties listed
below at all times with the exception of specified times off and hours you work at
Inclusion Union High School which I understand to be Monday through Friday
8:30 - 2:30. The agreed upon times off are Thursday 3:00 pm - 10:00 pm and Saturday
noon - 6:00 pm.
MY COMMUNICATION: I like to be involved in all decisions regarding my care. During

some parts of my care, I may not have my communicator. You may ask me a yes/no
question. I will answer "yes" by nodding head at the right side of my chair or by nodding
my head and saying "yeah." I will say "no" by shaking my head and saying "no" or
nodding toward the left side of my chair. If I cannot answer by yes/no I may look at
something or point towards something to give you a clue.
BATHING: I like to bathe or sponge bathe every evening. I want to bathe at least three
times per week. I like my hair to be washed every other day. When I bathe, you need
to undress me on my bed. Take off the Attends and catheter and help me to clean up
(see bowel and bladder care) and then wheel me in my manual chair to the bathroom
OR carry me from the bed straight into the bathroom. We can decide this beforehand.
Fill the bathtub about halfway with water on the warm side OR use the nozzle to give
me a shower. I will decide before my bath. Please test the water before you put me in
it. I like to use Head and Shoulders shampoo but I'm not particular about my soap or
conditioner. When rinsing the shampoo from my hair, hold the nozzle so that the water
is going back, away from my face and use one hand to block the shampoo/water from
going into my eyes. Dry me off as well as you can in the shower chair. Either lift me
into the chair and dry me off or carry me straight back to the bed to finish drying off.
Take me back to the room and lift me onto the bed. I like to put on powder after my
bath. I wear an Attends to sleep. I do not like to wear pajamas. If I am going to sleep, I
lie on my stomach so I don't choke. I also might like to stay up and watch television for
a while. Please be sure and clean up any spills and to throw away used diapers, bed
(Rev. 2/02) A-19

liners, and latex gloves because it is important to me that my room is clean. Please use
trash liners on the trash can so that it stays clean. If can gets dirty please clean it right
away. This trash should be thrown into the trash can outside every evening at least.
DRESSING: I like to choose the clothes and shoes that I wear. Please be sure to ask
me. I lay out my clothes the night before if it is a week night. I need full assistance to
get dressed.
HELP WITH BATHROOM:

* I like to brush my teeth in the morning after breakfast. I do not brush them at night.
* I shave in the morning after breakfast. Wet my face with a towel. Put on shaving
cream and shave me.
* Comb my hair in the morning and use hair spray.
BLADDER AND BOWEL CARE: During the day I wear a catheter and an Attends. I
must have my catheter bag emptied at noon and when I get home in the
afternoon/evening. At night, I only wear an Attends. Please throw away bed liners, dirty
diapers, and used gloves at least every evening and clean up spills immediately.
Catheter Care: First put a blue protector pad on the bed. It is best to put on the
catheter on while I am in bed. Clean area with a damp cloth or wipes. Dry off area.
Catheter is self-adhesive. After opening package roll down a little. Make sure pubOic
hairs are pulled back away from penis and when possible, trim them so not to interfere
with catheter. Roll catheter as far as it will go to the base of my penis. Rub catheter on
all sides to ensure that it is sticking properly. Apply a piece of tape to the base of the
penis attaching the catheter to the skin of my penis to ensure that it stays on properly.
Attach leg bag to catheter by inserting leg bag mouth into catheter tube as far as it will
go. A piece of tape can be applied around this area too, if needed. Place the top of the
leg bag strap around my left thigh and the second strap around my left calf. Make sure
that the drain valve has been closed after washing.
This is done while I am laying down. Unstrap the leg bag. Pull leg bag from connection
of catheter off. When taking my catheter off please use the Resolve if I have it to
dissolve the adhesive of the catheter. Take off tape, apply Resolve at the base of the
catheter, as it loosens begin to roll it off. Clean area and check for any skin breakdown
on penis. If skin breakdown occurs we may not be able to use the catheter for a day or
two.
Cleaning Catheter: After my catheter is off for the day, please rinse it with warm water
and a little bit of Urolux.
Attends: When I change my Attends I like to be cleaned using the squirt bottle of Easy
Care Perineal Cleanser and toilet paper to clean the anal and buttocks area. For some
people, it is easiest to wrap the toilet paper around your hand several times. In the
morning, I like to put on MicroGuard Anti-Fungal Powder. You may wear gloves to be
sanitary. Please use trash liners on the trash can so that it stays clean. If can gets dirty
(Rev. 2/02) A-20

please clean it right away. Please throw away used Attends outside at least once in the
evening.
LIFTING: I am most comfortable being lifted in the cradle position.
MEAL PREPARATION AND ASSISTANCE: I like to be asked what I would like to eat.
I don't eat chilies or hot sauce. I like my food to be cut in very small pieces. If the food
is not smooth, I may want you to mash the lumps i.e., big pieces of bean in refried
beans. I like to drink coffee with most meals. For a standard cup of coffee I like 2
teaspoons of creamer and 3 teaspoons of sugar. I like to wear a towel around my neck.
I usually have one in my bag on the back of my chair. Wipe my mouth often so I keep
clean and look good.
HOUSEKEEPING: Please clean the house for me because I like to live in a clean
home. Especially keep my room clean and empty the trash at least once per day.
LAUNDRY: Please change my sheets at least every other day per week.
SHOPPING: I would like to share the food with you. Please meet with me to make a
shopping list and I will need for you to purchase groceries for all meals.
OTHER:
(1) I would like you to clean my wheel chair thoroughly at least one time per week.
(2)
(3)
Reprinted with permission from CHOICESS, 135 E. Live Oak Ave., Suite #104, Arcadia, CA 91106.
(Rev. 2/02) A-21

DAY TIME TASK

Monday 6:00 am Get up
Change Attends
Put on catheter
Dress
Eat breakfast
Shave, comb hair, and brush teeth
Afternoon Empty catheter bag

Put in laundry
Prepare dinner
Put clothes in dryer
Assist me to eat
Help me to pack my bag and to lay out clothes for a.m.
Change my diaper and clean this area
Bathe me or Sponge bath
Tuesday 6:00 am Get up

Change Attends
Put on catheter
Dress
Eat breakfast

Put in laundry
Prepare dinner
Assist me to eat
(Rev. 2/02) A-22

Wednesday 6:00 am Get up

Change Attends
Put on catheter
Dress
Eat breakfast

Put in laundry
Prepare dinner
Assist me to eat
Thursday 6:00 am Get up

Change Attends
Put on catheter
Dress
Eat breakfast

Put in laundry
Prepare dinner
Assist me to eat
Friday 6:00 am Get up

Change Attends
Put on catheter
Dress
Eat breakfast
(Rev. 2/02) A-23

Friday Afternoon Empty catheter bag

Put in laundry
Prepare dinner
Assist me to eat
Saturday 8:00 am Get up

Change Attends
Put on catheter
Dress
Eat breakfast
pm Empty catheter bag
Put in laundry
Prepare dinner
Assist me to eat
Lay out clothes for a.m.
Sunday 7:00 am Get up

Change Attends
Put on catheter
Dress
Eat breakfast
Take me to church for 9:30 am services
pm Empty catheter bag

Put in laundry
Prepare dinner
Assist me to eat
Change my diaper and clean this area.
Reprinted with permission from CHOICESS, 135 E. Live Oak Ave., Suite #104, Arcadia, CA 91106.
(Rev. 2/02) A-24

INSTRUCTIONS FOR HOWARD
Here’s what one mother, also the conservator, uses when recruiting staff for the care of
her son. She asks prospective employees to read the instructions and to let her know if
there is anything that the person is not willing or is unable to do. The name has been
changed to protect the privacy of the consumer and the instructions are reprinted with
thanks to the family.
These instructions are written only to help whoever is in charge of Howard’s care. He
requires bodily function care and 24 hour supervision. I hope these instructions make
caring for him easier. Howard understands perfectly, even though he has a very bad
memory and has a terrible time communicating verbally. He is apt to forget very quickly,
and must be reminded of all areas of his needs continually. We continually repeat things
to him to see that he does not regress in memory. He knows he needs the help of
another person to survive and to help him with his bodily function care and bathroom
needs. He is not embarrassed easily, and hopes those working with him are not
embarrassed in doing the bodily function care he needs.
BATHROOM FUNCTIONS
Howard does not have any feeling as to his elimination of bowel or bladder, due to the
extent of his brain damage. He has been taught to handle his elimination needs with the
assistance of others concerned about him and his total care. He is unable to go to the
toilet unassisted. He must be transferred onto a commode bathroom chair, cleaned,
bathed, shaved, teeth brushed, groomed, manage his psoriasis condition, and then
dressed. He also has a tub bath every other day, but there are many times when a tub
bath will be better if he’s had bowel or bladder accident. He is on a very rigid toileting
schedule that has worked very well over all the years since his accident. If this schedule
is followed, it should not be difficult working with him. There will be times when things go
wrong, and he will have some bowel or bladder accidents. (I have had my share of
cleaning up accidents in 28 years.)
1. He must be transferred from his bed to the commode chair upon awakening, which
is anywhere from 6:30 a.m. to 8:00 a.m. He must be given his autoclavical (spill
proof) urinal while sitting on the commode chair (over the toilet). I tie it on with a
sash-like belting. If he cannot eliminate after 15 minutes, he must be given one or
two suppositories, inserted in his anus. If the suppositories don’t work, after another
10 to 15 minutes, he is then given an enema of warm water. If he still hasn’t
eliminated within an hour, he can be given a Fleet’s enema. There are times when
he will need digital stimulation. We have surgical gloves for those caring for him to
wear. He must eliminate completely before taking him back to his bedroom, before
dressing him, or he may have a bowel accident later in the day. All his bowel
problems are caused by an inactive colon. We are trying hard to not to have to have
any surgery on this whereby he would end up with an ostomy bag.
(Rev. 2/02) A-25

2. He uses his autoclavical urinal during the night and while on the toilet. Just hand it to
him and he knows what to do with it. While he is on the toilet, he uses a sash-type
tie on to hold the urinal in place.
3. During the day he uses an external condom catheter which can be worn all day
without problems if it is put on him as per special instructions attached. He doesn’t
wear it at night because he forgets he has it on and worries about it and he could
keep one up all night wanting his urinal. The urinal is spill proof, if handled correctly.
He prefers using the urinal at night. The autoclavical urinal is spill proof, and is easily
dumped by removing the funnel end of it. Be sure that the funnel end is put back on
the urinal properly, in the grooves, with the air vent on the top of the urinal, when it is
replaced. He does yell “MOM” sometimes at night if he wakes up and his urinal is
full. He also will wake up if he isn’t tired. One should reposition him, place his pillow
under his head and put the pillow between his legs, another small pillow is placed
under his right arm when he is sleeping on his right side. He also chokes on his own
saliva sometimes. I hear him coughing and have to raise the pillow portion of the bed
and give him a glass of water. Sometimes he has me up two or three times a night.
Other times he sleeps straight through. All this will be demonstrated to you before
working with Howard.
4. The condom catheter is used once and then thrown away. After taking the condom
catheter off at bedtime, it is always good to bathe the urinary area with a wash cloth.
If there are any signs of irritation, there are medications for this. After each bowel
movement, he should be wiped with toilet paper, then washed with a wash cloth. If
this isn’t done, in this manner, he can have serious skin breakdown problems. I have
several wash cloths for this purpose. Howard is capable of washing his urinary area,
if given a damp wash cloth, but one must check to see that he follows through with
the task, and that he has done it properly.
BEDTIME ROUTINE
Howard must be rolled over on his right side (his dormant side) upon retiring for the
night, and given his urinal. Bed liners are placed under him, and are usually already on
his bed. Once or twice a week he sleeps on his back with the pillow area and the foot
area raised a bit. He will let you know if it is too low. He doesn’t rest as well on his back.
He takes great care not to spill the urinal, but sometimes, if he fills it during the night, it
has spilled onto the bed liners and soiled the whole bed. Same goes for bowel
movements, but he has no control and accidents do happen. Bedding would then have
to be changed.
He uses just a top at night and no bottoms. It can be a pajama top, tee shirt, or tank top,
depending on the weather. This is so he can manage his urinal freely during the night.
His father or I get up, at least once a night, around 3 or 4 a.m. to dump his urinal
because he worries about it being too full. He has an obsession with his legbag and
urinal. When camping out, he cannot be zipped into a sleeping bag. The sleeping bag
(Rev. 2/02) A-26

must be left open and then another blanket is used as a covering. He cannot manage
his urinal when he is zipped into a sleeping bag.
DRESSING
Howard is incapable of dressing himself. We have tried several different techniques, to

no avail. He simply can’t dress himself. He can raise his body from a lying position on a
bed, if he is helped and encouraged to help you. I dress him while he is in a lying
position on his bed. He must have all his clothes put on for him. He has lots of clothes in
case of bowel or bladder accidents. He has to be undressed the same way. He can
have his shoes and shirts taken off while sitting in his wheelchair.
TRANSFERS
Howard must be transferred from bed to commode chair, from commode chair to bed,
from bed to his wheelchair, and from wheelchair to his lift chair. He can assist with his
left foot on the ground or floor. One must guide his body by turning it to wherever he is
being transferred. I will show how this is done when training someone to care for him.
MEDICAL
In extreme heat (directly on him) or if the weather is extremely hot, he has had very
severe grand mal seizures due to epilepsy. He is currently taking Dilantin 100 mg.,
Mysoline 250 mg., and Phenobarbital 30 mg. He takes mixed doses of Dilantin (3
capsules for 3 nights, then 4 capsules for 1 night, then back to 3 capsules for 3 nights,
then it’s repeated all week), 1 Mysoline, and 1 Phenobarbital at bedtime, approximately
between 9 p.m. and 10 p.m., and he takes 1 Dilantin in the morning while he is sitting on
the toilet. His doctor regulates this according to his Dilantin level. He has medicine
containers that help to remind one for administering his medicines. He takes all his
medications by swallowing one or two tablets or capsules, at a time, followed by a little
water. I have to keep reminding him to swallow and not keep the medication in his
mouth. He has a bad time swallowing liquids, and has a tendency to hold liquids in his
mouth for a while, and letting it trickle down his throat. One must be with him while he is
swallowing or he may choke. It’s also bad for his teeth to have the Dilantin breaking up
in his mouth. One must stay with him, and not go off and leave him while he is
swallowing his medications or eating, as he easily chokes. Howard has been diagnosed
to be intolerant to milk products. He uses lactaid milk and we have Lactaid caplets for
him to take when he wants ice cream, or some other diary product we are eating. His
doctor has prescribed taking Lactaid caplets after his second bite of food.
MEALS
Howard eats anything and everything, with the exception of milk products. He is not
allergic to any foods, but is intolerant to milk products. He enjoys food! We use Lactaid
milk on dry cereals and Mocha Mix for his coffee. When we are having ice cream for
desert, we give him 4 Lactaid caplets on the second bite of food. Bran muffins or
breads, and too much fresh fruit, have a tendency to move his bowels more than is
desirable.
(Rev. 2/02) A-27
He can feed himself with his left hand if one stabs the food with a fork, then hands it to
him BUT he makes an awful mess and he gets frustrated. At times he is so spastic that
I’ve found it best to feed him. Foods should be cut into small bite size as he can easily
choke. He should take time chewing, as that is one of the problems he has with gas and
choking, if he doesn’t chew his food well. We continually encourage him to take small
bites and to chew them well, slowly, and thoroughly, especially when he is eating a
sandwich. He has a big problem with swallowing, all due to the brain injury, and he
holds liquids in his mouth and lets them trickle down his throat. He can drink through a
straw, which is good during meal times.
ACTIVITIES
Howard may participate in any activities that he thinks he can do. He likes all types of
games, but has problems handling chips or markers used in some games. He likes
reading the paper, especially the sports section. He likes television and turns on
Channel 13, always, for some unknown reason. He likes playing “21" with cards. He
also has an electronic “21" game. Howard has gone into a swimming pool, but must be
accompanied, and cannot be left alone at any time. He must wear a life jacket and
earplugs. He is very susceptible to ear infections if he doesn’t use earplugs. He tries to
swim on his left side, but struggles to keep himself afloat. He cannot go into deep water.
Most of his pool activities have been under the guidance of a therapist.
NOTE: These instruction have been written up to help all those who take care of
Howard. He requires a lot of bodily care and he is a lot of work. I, his mother, have
cared for him for 27 out of 28 years, since his accident, and I am fully aware of what he
is, or is not, capable of doing. He has been through several day programs and activity
centers, day camps and summer camps and always considered too much work.
He has been seen by the best of doctors, therapists, recreational therapists,

rehabilitation experts and activity professionals. We have had him everywhere for
evaluations and re-evaluations. His brain injury was in a area that does not repair itself.
Anyone that works with him can try new approaches, but don’t expect too much. I find it
best to accept Howard for what he is and what he has relearned to do. He can be very
demanding and one must take that into account and continue to encourage him to be
less demanding. Howard has a very bad memory and can’t remember what is said to
him, in all areas of present communication and especially in the form of instructions, for
very long. We constantly remind him to hold his head straight, and to sit up straight in
his wheelchair and lift chair. Sometimes he leans to the left and almost falls out of his
wheelchair. He also forgets, and tries to go down the ramps, unassisted, and has taken
some big spills out of his wheelchair. He requires 24 hour care and supervision.
Written by:
_____________, Howard’s mother, conservator and primary caretaker.
(Rev. 2/02) A-28

Sample Job Description
Job Description
Position Title: Personal Attendant/Roommate

Supervisor: __________________________
Hours of Work: Varies, as needed
Salary: Open
Role:
The roommate/personal assistant may or may not live with the client and provides
support in the home and in the community. This may include sleepover, household
management, light housekeeping, shopping, recreational activities, accompany with and
or arranging transportation, assistance with communication and other duties as outlined in
their person centered plan. The roommate/personal assistant is expected to be responsive
to the client's instructions and requests regarding duties and conduct at all times.
Requirements:
1. Education and Experience: High School Diploma or equivalent. Experience

providing direct service in the human services, particularly with developmentally disabled
persons.
2. Other: An understanding and commitment to individuals being empowered, making

their own choices, and living in their own homes. The ability to communicate effectively.
Ability to work with the client in providing support. The ability to work consistently with
agency philosophy and service design. A record of punctuality, good work attendance and
reliability. Willingness to provide documentation required, to obtain First Aid/CPR
certification and any necessary training required by the agency or those authorities
regulating the agency.
Duties and Responsibilities:
1. Provide support in home, work, transportation and in social/recreational

environments as needed.
2. Communicate all information related to supporting the client to appropriate agency

staff in a timely manner (problems with equipment, transportation, housing).
3. Attend staff meetings, ISP meetings and other meetings requested by the client or
agency supervisor.
4. Assure client health and safety during assigned work hours. Provide any needed
emergency intervention.
(Rev. 2/02) A-29
5. Complete all necessary "paperwork" accurately and in a timely manner.
6. Report to work on time and as defined by the schedule. Provide at least two weeks
notice to any supervisor of any planned leave. Notify client and supervisor as soon
as possible of any emergency absences. (Excessive absences or tardiness is
grounds for termination.)
7. Agree to specific contract with the client and immediate supervisor detailing specific
duties and scheduling. (Scheduling and specific duties are based on client need and
preferences and are subject to change.)
8. Report any suspected abuse to supervisor immediately. Also report any decline in
client's health, any problems with medication, or any condition that threatens the
person's ability to live in the community safely.
9. Utilize Universal precautions at all times when dealing with body fluids.
10. Report workplace safety issues, needed repairs in the home, client threats to staff
or self, potential liabilities, or worker injuries to the supervisor immediately. Report
any request for a new roommate or personal care assistant or any other expressed
dissatisfaction with agency service.
11. Complete SLS training curriculum and other training as assigned.
I understand that this job description, in part, governs my employment. I further understand
that employment is at-will by the ____________________.
Signature Date
(Rev. 2/02) A-30

ELDER CARE CERTIFICATION (Section 15660 Welfare and Institutions Code)

GUIDELINES FOR FINGERPRINT CARD SUBMISSION
Background
The Bureau of Criminal Identification and Information (BCII) provides state summary
criminal history information to employers of persons who are unlicensed and providing non-
medical domestic or personal care to an aged or disabled adult in the adult's own home
pursuant to Section 15660 of the Welfare and Institutions Code. As defined:
"Elder" means any person residing in this state, 65 years of age or older.
"Dependent Adult" means any person residing in this state, between the ages of 18
and 64, who has physical or mental limitations which restrict his or her ability to carry
out normal activities or protect his or her own rights.
Procedures for Submission
Please submit a completed 10 print applicant fingerprint card (BID-7). Each request must
be accompanied by a $32 processing fee. Checks or money orders should be made
payable to Department of Justice. Attached is an instruction sheet for your reference.
Release of Information
Welfare and Institutions Code 15660 limits the criminal history information which can be
released. Under this section, you will only receive information on the following:
C Arrests for specified sex offenses against a minor, sexual battery, willful cruelty
to a child, inflicting injury upon a child, cruelty to an elder or dependent adult,
theft, robbery, burglary or any felony offense.
C Arrests for specified offenses that have resulted in conviction or indicate active
prosecution.
Criminal record information for specified offenses will only be released if the arrest occurred
within 10 years of the date of the employer's request.
For Further Information
If you have further questions regarding this process, contact Frieda Hilburn at
(916) 227-3811.
(Rev. 2/02) A-31

RESOURCE MATERIALS
Galloway, Charles, (1994). Final Report Comprehensive Attendant Management Services:

A Targeted Program Development Fund Project 1993-94. Training Towards Self Reliance,
2755 Cottage Way, #2, Sacramento, CA 95825.
Ulicny, Gary R.; Adler, Amy B.; Kennedy, Sara E.; Jones, Michael L. (1987) A Step-By-Step
Guide To Training And Managing Personal Attendants: Volume 1: Consumer Guide. The
Research and Training Center on Independent Living, University of Kansas, Lawrence, KS
66045.
Ulicny, Gary R.; Adler, Amy B.; Kennedy, Sara E.; Jones, Michael L. (1987) A Step-By-Step
Guide To Training And Managing Personal Attendants: Volume 2: Agency Guide. The
Research and Training Center on Independent Living, University of Kansas, Lawrence, KS
66045.
Powell, Lynda; Ulicny, Gary, Mikesic, Bob. (1990) The Personal Assistance Referral Pool
Manual: How to Start a Consumer-Directed Pool of Personal Assistants. The Research
and Training Center on Independent Living, University of Kansas, Lawrence, KS 66045.
Hom, Leslie (1983) The Employer’s Handbook: Basic tips on Managing Personal
Assistants. Stanford University, Palo Alto, California.
The energy challenge facing California is real. DDS encourages

practical and feasible energy saving measures while considering the
health and safety of clients, workers, and family members.
A-39

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PERSONAL ASSISTANCE SERVICES (PAS)

HEALTH AND HUMAN SERVICES AGENCY

DEPARTMENT OF DEVELOPMENTAL SERVICES

It is important to remember that laws applicable to employee/employer relationships,

California Welfare & Institutions Code (W & I Code)

Sections 12300 – 12316

All California Statutes http://www.leginfo.ca.gov/calaw.html

Manual of Policies and Procedures (MPP)

HOW TO DISMISS AN ASSISTANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

(Rev. 2/02) iii

< CCR . . . . . . . . . . . . . . . . California Code of Regulations

< Conservator is a person who is appointed by the court to protect and to

< In-Home Supportive Services (IHSS) provides assistance to those eligible

< Natural Supports means personal associations and relationships typically

Failure of the relationship between a consumer and an assistant may be seen in a

SUPPORTED LIVING SERVICES AGENCY

WHAT kinds of services?

Personal care services include:

C Ambulation C Feeding and fluid intake

Domestic services include:

C Sweeping, vacuuming, washing and C Taking out garbage

Related and Other services include:

C Preparation of food C Help to participate in work, home or

Paramedical services include:

C Administration of medications C Inserting a medical device into a

WHERE does the money come from?

IN-HOME SUPPORTIVE SERVICES (IHSS)

Eligibility for IHSS

< Medically needy aged, blind or disabled. [W & I Code §14132.95]

< Otherwise eligible applicants who are currently institutionalized or in a licensed

Eligibility for IHSS (PCSP) is limited to individuals who:

< Do not receive advance IHSS payment [MPP 30-780.4];

MEDICARE HOME HEALTH

FIRST THINGS FIRST – PLANNING

Assessing Support Needs

‚ * How do you communicate? If facilitation is needed, who will do this?

‚ * Do you have a language and/or cultural preference?

Meeting Support Needs and Preferences

‚ How many people are needed to provide the services?

‚ What would be best: come-in assistant, live-in assistant, housemate/roommate or

‚ What will be done about having back-up assistance available?

‚ Is a list of non-verbal methods of communication needed?

‚ Will the personal assistant(s) be given a key to the home?

Health and Safety

‚ Is a job description needed? Who will write it?

‚ Will a background or fingerprint check be required to screen for certain types of

‚ Will references be required?

‚ Will a Department of Motor Vehicles printout be required to check the assistant’s

Living Arrangements (physical/environmental)

‚ How will be rental agreement be handled?

‚ Which living areas will be shared and which will be private?

‚ How will utilities and rent be shared?

Characteristics of a Personal Assistant

< Clean and neat.

< Experience, if required.

HOW ARE YOU GOING TO RECRUIT?

Family and Friends

Colleges, Universities and Vocational Schools

Community Bulletin Boards

Independent Living Centers

_ has recently applied to be my attendant. ___