Private Duty Care Plan Checklist

A private duty care plan tells caregivers what to do, how often, and what “good care” looks like for this client. It should match the signed service agreement. When those two documents disagree, families get confused and agencies get disputes.

Private duty care plan checklist

Use this list on every new client and every material change of condition.

Client and household

☐ Preferred name and pronouns

☐ Address, access instructions, parking, pets

☐ Emergency contacts and decision makers

☐ Who else lives in the home

Goals

☐ Why the family hired care (one or two clear goals)

☐ What success looks like in 30 days

☐ Client preferences the team must respect

ADLs and IADLs

☐ Bathing, dressing, toileting, transferring, mobility

☐ Meals, med reminders (if in scope), housekeeping, errands

☐ Level of assist for each task (independent, cue, hands-on)

Schedule and staffing

☐ Days and hours of service

☐ Preferred caregiver traits when relevant

☐ Backup plan when the assigned caregiver is out

Safety

☐ Fall history and high-risk areas in the home

☐ Oxygen, smoking, weapons, or other hazards noted per policy

☐ When to call 911 vs the agency on-call line

Alignment with the contract

☐ Services on the care plan appear on the service agreement

☐ Rates and hours match what was sold

☐ Start date and review date are written down

How often to update the care plan

Update after a hospital return, a clear change in ADLs, a schedule change, or a family complaint about scope. Do not wait for an annual review if daily reality has already moved.

Related templates and tools

Home care care plan template

How to write a home care service agreement

Home care documentation software

PalmCare AI drafts the care plan from the recorded assessment alongside visit notes, billables, and the state-specific contract so the set stays consistent. Start a free trial or book a demo.