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Good [3ealth Serviczs Inc. <br />ATTACHMENT B- Scope of Work <br />Federal Tax Id. or SSN 56-1372342 <br />A. CONTRACTOR INFORMATION <br />1. Contractor Agency Name: Good Health Services Inc. <br />2. If different from Contract Administrator Information in General Contract: <br />Telephone Number: Fax Number: <br />3. Name of Program (s): <br />4. Status: () Public () Private, Not for Profit ( X) Private, For Profit <br />5. Contractor's Financial Reporting Year 7-1-2007 through 6-30-2008 <br />B. Explanation of Services to be provided and to whom (include SIS Service Code): <br />The Contractor agrees to provide qualified in-home aides and Registered Nurses <br />(RNs) to provide the following service on an as needed basis: direct client care. <br />Contractor and its agents and employees shall: <br />A. Provide In-Home Services as directed by CCDSS. <br />B. Provide all services in accordance with a plan of caze established by CCDSS. <br />C. Provide all services in accordance with approved policies and procedures; state <br />and federal laws, rules, and regulations; and currently approved methods, <br />standards of practice and codes of ethics in the medical service community. <br />D. Maintain records and reports which constitute clienYs record, including notes and <br />personal observations of the clienYs progress and notification of planned visits. <br />E. Maintain the confidentiality of all records and information in accordance with <br />state and federa] laws, rules, regulations and policies of the county. <br />F. Additional contractor responsibilities through Registered Nurses (RNs) are as <br />follows: <br />a. Annual Physical Health Assessments for current CAP/DA clients <br />b. Physical Health Assessments for new CAP/DA clients <br />c. Assessment and Plan of Care for new PCS clients <br />d. Aruiual Assessments and Plan of Care for cuirent PCS clients <br />e. Home visits with PCS clients every 60 days <br />f. Quarterly supervisory visits with CNAs <br />G. Maintain on file verification of the qualifications of its personnel, including the <br />following: <br />a. Current application <br />b. Current NA I listing, when applicable <br />c. Results of annual tb test. If the individual has a positive TB test, there <br />must be annual documentation (chest x-ray) from a physician that he/she <br />is free of communicable disease <br />Contract-Scope of Work (06/04) ~~ Page lof 1 <br />