OAC 173-39-02.12 · Staff Education & Competency Verification
Dulla Care Home Healthcare
In-Person Training · Sign-In Sheet · Post-Training Knowledge Check · Supervised Documentation Review
📋 Training Purpose
This training provides documented education to M. Henley, A. Worden, and A. Johnson on service verification requirements, with emphasis on accurately documenting tasks performed during each service visit. Training is conducted in-person, documented with sign-in sheets, and competency is verified through a post-training knowledge check and supervised documentation review.
| # | Trainee Name | Present? | Signature | Sign-In Time | Sign-Out Time | Knowledge Check Score | Competency Verification |
|---|---|---|---|---|---|---|---|
| 1 | M. Henley | ||||||
| 2 | A. Worden | ||||||
| 3 | A. Johnson |
Each trainee completed the following verbal/written knowledge check. Trainer records pass/fail and notes.
M. Henley
Score: —
Result: Pending
A. Worden
Score: —
Result: Pending
A. Johnson
Score: —
Result: Pending
Following the training session, the trainer supervised each trainee completing a sample service documentation entry to verify competency in accurately recording tasks performed during a service visit. The trainer reviewed the documentation for accuracy, completeness, and compliance with agency standards.
| Trainee | Documentation Reviewed (Date & Visit Type) | Accuracy | Completeness | Trainer Signature |
|---|---|---|---|---|
| M. Henley | ||||
| A. Worden | ||||
| A. Johnson |
I, [Trainer Name], in my capacity as [Title], attest that the above-named trainees — M. Henley, A. Worden, and A. Johnson — received documented in-person education on service verification requirements with emphasis on accurately documenting tasks performed during each service visit. Training attendance was documented via sign-in sheet, and each trainee's competency was verified through a post-training knowledge check and supervised documentation review. This training record is retained in the personnel file of each trainee and the administrative training file.
Trainer Signature
· 2026-10-28
Administrator / HR Director Signature
Date
Dulla Care Home Healthcare · Service Verification Documentation Training · OAC 173-39-02.12 · Retained in Personnel & Administrative Files · Confidential