Edit with
Date
Wednesday, October 28, 2026
Pay Period
Week
Pay Date
| Employee Name | Sign In (Office) | Sign Out (Office) | Left to Field | Returned from Field | Mileage | Notes |
|---|---|---|---|---|---|---|
| Carmelethia Johnson | ||||||
| Chief Kelley | ||||||
| David Stein | ||||||
| Ebony Smith | ||||||
| Shallote Foncham | ||||||
⚠️ Employee Acknowledgment & Disclaimer
All employees are required to sign in and sign out each day while at work. This includes signing in and out when leaving the office to go into the field and upon return. Failure to properly sign in and/or out constitutes a violation of company policy. Employees found in violation may be subject to disciplinary action, up to and including the withholding of payroll, written warning, suspension, or termination, in accordance with Dulla Care Home Healthcare's policies and procedures.
Human Resources Approval
HR Signature & Date
Director's Approval
Director Signature & Date
Dulla Care Home Healthcare · Internal Use Only · Confidential