ROSEBUD HEALTH CARE CENTER
POSITION DESCRIPTION/ANNUAL EVALUATION

Department Name/Number Position Title Reports To

PALS Personal Care Assistant PALS Manager

Written or Revised: 05/2017 Supervisor Signature/Date:

Position Grade: 10 Administration Signature/Date:
Status: Non-Exempt Human Resources Signature/Date:

Employee Name:

Hire Date: Evaluation Due in Human Resources on:

Reason for Evaluation: 6 Month __ ___ Annual _____ Special _____

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The
requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions.
POSITION SUMMARY STATEMENT: (in 1 or 2 sentences, describe why the job exists)
In this position, the Personal Care Assistant is responsible for the personal care assistance and light
housekeeping of the clients in the PALS program, as delegated by the PALS Manager.
ESSENTIAL DUTIES & RESPONSIBILITIES:
1. Responsible for assistance of the client in relation to their personal hygiene, such as bathing, showering,

oral hygiene, etc.
2. Assist client with dressing and handling of clothing and other personal items: dentures, hearing aids, glasses, and

prosthetics.
3. Assist client with meals, including meal preparation, if necessary, menu planning, grocery shopping, and

assistance with feeding.
4. Assist client with medication by giving reminders to take medications, as prescribed.
5. Responsible for safety of client while providing assistance and observation of possible risks in client environment.

• Know client’s fall risk status and assist in implementing fall risk interventions.
• Responsible for the safe transfer of clients. Must be able to assist with transferring client in and out of

6. Responsible for various household tasks as assigned, including changing bed linens, washing dishes, light
housekeeping, etc.

7. Responsible for medical escort services, if assigned by PALS Manager. This service is reserved only for those clients
who are pre-approved for medical escort.

• Knows and follows chain of command.
• Responsible for attending all mandatory in-services, staff meetings, and keeping current on education hours, as

interactions.
9. Documentation

• Responsible for proper completion and understanding of the importance of required documentation.
• Follows plan of care and reports any changes or discrepancies to PALS manager.

The employee will demonstrate the ability to: manage time, maintain a safe and clean environment, practice
confidentiality, treat all persons with respect and professional courtesy, accept change, support the mission and
vision of Rosebud Health Care Center (RHCC), accept and provide constructive feedback, be a team player, and
adhere to the infection control, fire and safety, disaster and hazardous waste policies. The employee must also
demonstrate the competencies for the position and adhere to policies and procedures for their department.

A review of this description has excluded the marginal functions of the position that are incidental to the
performance of fundamental job duties. This job description in no way states or implies that these are the only
duties to be performed by the employee occupying this position. Employees will be required to follow any other
job-related instructions and to perform other job-related duties requested by their supervisor in accordance with
regulatory, legal, and organizational policies and procedures.

Education, Experience and Licensure/Certification Requirements: Requirements are representative of the
minimum level of knowledge, skills and/or abilities necessary to perform the essential functions of the position.

1. High School Graduate or equivalent
2. Certified Nursing Assistant Certificate, preferred

Reporting Relationship: Reports to PALS Manager
Employees Supervised: N/A
Physical Demands
Checked are the physical requirements that apply to this position

Sedentary-Primarily sitting/lifting 10 lbs maximum
Light-Lifting 20 lbs maximum with frequent lifting/carrying up to 10 lbs
Medium-Lifting 50 lbs maximum with frequent lifting/carrying up to 20 lbs
Heavy-Lifting 100 lbs maximum with frequent lifting/carrying up to 50 lbs
Very Heavy-Lifting objects over 100 lbs with frequent lifting/carrying up to 50 lbs

Checked are the appropriate factors for this position
Occasionally 0-33% of the work shift
Frequently 34-66% of the work shift
Constantly 67-100% of the work shift
N/A Not Applicable for this position

Physical Factors N/A Occasionally Frequently Constantly
Standing
Walking
Sitting
Pushing (wt 50 )
Pulling (wt 50 )
Stooping
Kneeling
Crouching
Reaching
Filing
Typing (Computer)
Copying
Talking
Hearing
Visual Acuity
Driving
Environmental Factors
Exposure to Weather
Extreme Heat
Extreme Cold
Noise
Dust, Vapors, Fumes
Odors
Bloodborne Pathogens Checked is the appropriate category for position

Category I - Job classification in which tasks involve exposure to blood, body fluids or tissue
Category II - Job classification in which tasks involve no exposure to blood, body fluids or tissue but employment
may require performing unplanned Category I tasks

Category III - Job classification in which tasks involve no exposure to blood, body fluids or tissues and Category tasks
are not a condition of employment

Protective Equipment Checked is the equipment that may be required to be worn in this position
Not Applicable
Hearing Protection Gloves Goggles Safety Glasses Face Shields
Face Masks-Surgical, N95, Respirator Moisture Resistant-Gown/Lab Coat

I have read and understand the above job description. I hereby certify that I am qualified and able to
perform all the above functions, duties and physical demands. I will perform this job to the best of my
ability.
Name Date

PERFORMANCE EVALUATION

Employee Name: Position: Personal Care Assistant

Department: PALS

Evaluated By: Position: Pals Manager

Period of Review: to:

PART ONE: ESSENTIAL JOB FUNCTIONS

These are five Essential Functions/Duties/Responsibilities on which the employee is to be evaluated for the job
description assigned. Provide a written description of the performance demonstrated and write the performance
level achieved by the employee, based on the scale described below, in the final column.

PERFORMANCE LEVELS
5 Exceeds all requirements 4 Exceeds many requirements 3 Meets normal requirements
2 Improvement is needed to meet normal requirements 1 Fails to meet requirements

1. Duty/Responsibility: Responsible for the care of the clients in relation to their personal hygiene,

ambulation assistance, meal preparation, and household duty assistance. Makes client safety and
comfort a priority.
Performance:________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

2. Duty/Responsibility: Follows plan of care and reports any changes or discrepancies to the PALS

Manager.
Performance:________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

3. Duty/Responsibility: Responsible for the proper completion and understanding of the
importance of all required documentation.
Performance:________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

4. Duty/Responsibility: Understands the importance of being a part of a team and behaves in a

manner exhibiting that understanding.
Performance:________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

5. Duty/Responsibility: Adheres to all Policies and Procedures established by the facility and
PALS department.
Performance:________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

6. Duty/Responsibility: Responsible for medical escort services, if assigned by PALS Manager. This

service is reserved only for those clients who are pre-approved for medical escort.

Performance:________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

TOTAL SCORE:

PART TWO - GENERAL PERFORMANCE FACTORS

The following performance factors tend to reinforce the performance level identified in Part One. Provide a written
description of the performance demonstrated and write the performance level achieved by the employee, based on the
scale described below, in the final column.
PERFORMANCE LEVELS
5 Exceeds all requirements 4 Exceeds many requirements 3 Meets normal requirements
2 Improvement is needed to meet normal requirements 1 Fails to meet requirements

1. Quality of Work: Ensures accuracy and completeness of work performed. Work Ethic: When
assigned work is complete, seeks additional tasks to be done.
Remarks: ___________________________________________________________________
___________________________________________________________________________

2. Initiative: Ability to originate / develop / implement constructive ideas and solutions to problems.
Judgment/Decision-Making: Ability to analyze situations and arrive at logical, practical decisions.
Remarks: ___________________________________________________________________
___________________________________________________________________________

3. Dependability: To what extent can he/she be counted on to fulfill responsibilities?
Remarks: ___________________________________________________________________
___________________________________________________________________________

4. Communication Skills: Provides oral or written information in a clear, concise manner.
Remarks: ___________________________________________________________________
___________________________________________________________________________

5. Teamwork: Exercises tact, courtesy, and flexibility in relationships with others and enhances task
accomplishment through positive supporting cooperation. Channels concerns appropriately, deals with
conflict appropriately and privately.
Remarks: ___________________________________________________________________

___________________________________________________________________________
6. Ethics and Integrity: Complies with policies, regulations and codes of conduct governing all aspects

of job responsibilities. Maintains confidentiality of patient and employee information in verbal, written
and electronic information.
Remarks: ___________________________________________________________________

___________________________________________________________________________
7. Attitude: Consistently displays behavior that enhances the image of the organization.

Remarks: ___________________________________________________________________
___________________________________________________________________________

8. Education/Development: Attends department staff meetings, in-service programs, and completes
Silver Chair Learning assignments on a regular basis.
95-100% = 5 85-95% = 4 80-85% = 3 70-80% = 2 Below 70% = 1
Remarks: ___________________________________________________________________
___________________________________________________________________________

9. Attendance/Reliability: Absence/Tardy occurrences are within policy guidelines:
90 day: Perfect Attendance = 5 Annual: Perfect Attendance = 5
1 or less day = 3 2 or less days = 3
2 days = 1 3 - 5 days = 2
3 days = possible termination 6 or more days = possible termination
Remarks: ___________________________________________________________________
___________________________________________________________________________

TOTAL SCORE:

PART THREE - DETERMINING THE OVERALL EVALUATION

Add the Total Scores of the performance level for each criteria in Parts One and Two.
Divide the Total Scores from Parts One and Two by the total number of criteria (15) to determine the average or Overall
Evaluation Score.
Indicate the Overall Evaluation Score here: _____________

Strengths/Accomplishments: List areas of job performed well during the past year
Goals for coming year:
Skills Improvement/Performance Improvement Plan
List areas for improvement and identify resources available or needed to attain improvement
Manager/Supervisor Comments
Manager/Supervisor Signature:_______________________________________________ Date:_____________

Please sign on the line below to indicate that you have had an opportunity to review and discuss your
performance evaluation with your supervisor. Your signature will also indicate that you are aware of and have
discussed the Performance Improvement Plan which has been established and will be reviewed in your next
performance evaluation.
Employee’s Comments:
Employee’s Signature: ________________________________________ Date: ______________________
Your signature does not indicate that you agree with the performance evaluation.

SUPERVISOR: PLEASE RETAIN A COPY OF THIS APPRAISAL
FOR YOUR RECORDS