Personnel File Audit Tool
Personnel Name: _______________________
Title: _________________________________
Date of Hire: ___________________________
| Item | Present | Absent | Follow-Up Needed | Comments |
|---|---|---|---|---|
| Employment Documents | ||||
| Employment Application (not for contractors) | ||||
| Resume | ||||
| Interview Review Form | ||||
| Two References | ||||
| New Hire Form | ||||
| Credentials & Licenses | ||||
| License Copy with Online Verification (for field staff) | ||||
| Diploma/Degree/Certificate (if required) | ||||
| Social Security Card / I-9 Verification | ||||
| CPR Card (for field staff) | ||||
| Driver’s License (for field staff) | ||||
| Auto Insurance (for field staff) | ||||
| Orientation & Job Requirements | ||||
| Orientation Checklist | ||||
| Job Acceptance Statement | ||||
| Job Description | ||||
| Performance Evaluation (at least yearly) | ||||
| Skills Competency Evaluation (on hire and yearly for direct care) | ||||
| Annual Evaluations & Training | ||||
| On-Site Joint Visit (yearly for direct care) | ||||
| In-Services: Bloodborne Pathogens, Infection Control, TB, HIPAA, Cultural Diversity, etc. | Required on hire and annually for direct caregivers | |||
| Office In-Services: HIPAA, Cultural Diversity, Emergency Training, etc. | Required on hire and annually for office staff | |||
| Policy Acknowledgments | ||||
| Employee Handbook Receipt (not for contractors) | ||||
| State-Specific In-Service Requirements | ||||
| Conflict of Interest Statement | ||||
| Confidentiality of Protected Health Information | ||||
| E-Signature Statement (for field staff) | ||||
| Field Practices Statement (for field staff) | ||||
| Corporate Compliance Statement | ||||
| Policies and Procedures Statement | ||||
| Protective Equipment Statement (for field staff) | ||||
| Termination Documents | ||||
| Exit Interview | ||||
| Contractors Only | ||||
| Independent Contractor Agreement | ||||
| Contract Annual Review | ||||
| Professional Liability Insurance (current) | ||||
| Confidential Folder Requirements | ||||
| Payroll Forms (W-4 or W-9) | ||||
| Physical / "Free of Communicable Disease" (if required by state) | ||||
| Health Statement | ||||
| 2-Step TB Skin Test or BAMT (no older than 10 days) | ||||
| Annual TB Questionnaire | ||||
| Immunizations (if state required) | ||||
| Hepatitis Declination/Acceptance Form | ||||
| Criminal History Background Results | ||||
| OIG Clearance | ||||
| National Sex Offender Clearance | ||||
| Motor Vehicle Record (if employee drives patients) | ||||
| I-9 Documents (current, not for contractors) |
Audit Details
Date of Audit: _________________________________________________________
Name of Auditor: ______________________________________________________
Signature and Title of Auditor: ___________________________________________
This tool streamlines the audit process by categorizing items for easy reference and adding a Comments column for specific notes. It ensures a clear, consistent approach to personnel file compliance.
___________________________
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