Care Documentation

Aide Skills Assessment Checklist

Name: My Home Cares
Address: MD, US
Telephone: (410) 231-3076

A skills, assessment, and demonstration checklist the RN uses to observe and certify an aide's competency across more than fifty patient-care skills, with satisfactory Yes/No, date, and observing RN for each.

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CNA / Unlicensed Aide Skills, Assessment & Demonstration Checklist

Staff nameCaregiver numberDate

Skills assessment & demonstration

Mark each skill Satisfactory (Yes/No), with the date demonstrated and the observing RN.

#	Skill assessment & demonstration	Satisfactory
1	Assist with admission of patient	Yes No
2	Assist with ambulation	Yes No
3	Positioning patients	Yes No
4	Assist with toileting: bedpan	Yes No
5	Assist with toileting: urinal / commode	Yes No
6	Backrubs / back care	Yes No
7	Bathing: complete bath	Yes No
8	Bathing: partial / sitting	Yes No
9	Bathing: tub bath	Yes No
10	Bathing: bed bath	Yes No
11	Bathing: shower	Yes No
12	Oral hygiene	Yes No
13	Dressing a patient	Yes No
14	Transfer assistance (up to 250 lbs)	Yes No
15	In / out of bed to a chair	Yes No
16	Transfer to wheelchair	Yes No
17	Assistive devices: lift	Yes No
18	Assistive devices: wheelchair	Yes No
19	Assistive devices: walker	Yes No
20	Assistive devices: cane	Yes No
21	Assistive devices: other	Yes No
22	Nourishment: feeding assistance (aspiration precaution)	Yes No
23	Medication reminders	Yes No
24	Documentation / charting: patient care & report events to RN	Yes No
25	Infection control precautions	Yes No
26	Hand washing, use of gloves / sanitizer	Yes No
27	Standard universal precautions	Yes No
28	Reverse isolation	Yes No
29	TB / airborne precautions	Yes No
30	MRSA / VRE precautions	Yes No
31	Bed making: occupied / unoccupied / surgical	Yes No
32	Bed cradles	Yes No
33	Bed rails: when to use	Yes No
34	Cast care	Yes No
35	Compresses: warm, cold	Yes No
36	Foley catheter: care & emptying	Yes No
37	Perineal care	Yes No
38	Intake & output: measure & record	Yes No
39	Range of motion exercises	Yes No
40	Reporting changes of patient condition	Yes No
41	Reporting / recording patient's pain level	Yes No
42	Specimen collection: routine urine	Yes No
43	Specimen collection: clean catch	Yes No
44	Specimen collection: 12 & 24-hour	Yes No
45	Specimen collection: stool	Yes No
46	Specimen collection: culture	Yes No
47	Specimen collection: sputum	Yes No
48	Specimen collection: from Foley catheter	Yes No
49	Demonstrate taking vital signs	Yes No
50	Prosthetic devices	Yes No
51	Care of dentures	Yes No
52	Contact lenses	Yes No
53	Other	Yes No

Any notation of "No" will require further training and orientation to meet job requirements.

CNA skills assessment satisfactorily completed

YesNo

Evaluator (RN, print & sign) · Signature / Date

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What this form captures

Our care team uses the aide skills assessment checklist to keep care consistent, safe, and clearly communicated with families and providers. It typically records:

50+ patient-care skills
Satisfactory Yes/No
Date demonstrated
Observing RN & sign-off

Questions about our documentation and care planning? Our team is happy to help, reach out any time.

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