Personal Care Assistant Daily Encounter Log
|Personal Care Assistant Daily Encounter Log |Sheet: | |of: | |
| | |
|Student Information |
|LEA Name: | |Date: | |
|Student Name: | |DOB: | |PA Secure ID#: | |
|Diagnosis: | |
| |
|Provider Information |
|PCA: | |Signature: | |
|PCA: | |Signature: | |
|PCA: | |Signature: | |
|PCA: | |Signature: | |
|Time In |Time Out |Minutes |
|Service Type | |Progress Indicator Key |
|D- Direct Session | |MN- Maintaining |MS- Mastering |
| | |RG- Regressing |IN- Inconsistent |
| | |PR- Progressing | |
|Supervisor Name: | |Signature: | |Date: | |
|Personal Care Assistant Daily Encounter Log |
Treatment Key:
|1 |Direct |Assisting the student to use equipment. |
|2 |Direct |Assisting the student to use and maintain augmentative communication devices. |
|3 |Direct |Assisting the student to ambulate, position and transfer. |
|4 |Direct |Range of motion and other exercises. |
|5 |Direct |Activities of daily living such as eating, grooming, bathing, toileting, etc. |
|6 |Direct |Monitoring the incidence and prevalence of designated health problems or medical conditions, e.g. seizure precautions or extreme lethargy. |
|7 |Direct |Hands-on assistance, cueing, or supervision of medical/mental health related services provided by the PCA under the direct (on-site) supervision of |
| | |the professional nurse. Activities may include catheterizations, suctioning, oxygen admin, and tube feedings. |
|8 |Direct |Observing and intervening to redirect inappropriate behavior. |
|9 |Direct |Assisting, monitoring, and guiding the student to pay attention, participate in activities, and complete tasks. |
|10 |Direct |Accompanying students on school buses or other vehicles. A PCA’s presence is necessary because of a student’s physical disability of mental health |
| | |disability. |
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