Care Worker Shadow Form

Care Worker Shadowing Feedback Form

Employee First Name

Employee Last Name

Name of Senior Staff You Shadowed

Date

EMPLOYEE OBSERVATION

For each of the following areas, rank how good you think you were able to observe and take in. Use the comments to section to discuss all items which rank Fair or lower.

Can you use the electronic monitoring system (Birdie) and understand all the functions on it?

Excellent

Good

Fair

Poor

Comments

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Do you know where to find the necessary equipment’s to provide personal Care for service users?

Excellent

Good

Fair

Poor

Comments

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Do you know where the essential items are kept when preparing meals/Hot drinks for the service users?

Excellent

Good

Fair

Poor

Comments

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Are you reaching on time to the Service Users at the allocated time given?

Excellent

Good

Fair

Poor

Comments

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Do you know who and how to report regarding any Concerns/issues?

Excellent

Good

Fair

Poor

Comments

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Do you know where to get the PPE from and who to contact when running out of PPE?

Excellent

Good

Fair

Poor

Comments

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Do you know where the Care plan, history of Service Users is kept?

Excellent

Good

Fair

Poor

Comments

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Do you know how to record on the MAR chart, and can you assist with Service Users Medication?

Excellent

Good

Fair

Poor

Comments

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Can you communicate with your service Users and able to support their needs?

Excellent

Good

Fair

Poor

Comments

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Do you and your colleague communicate and work as a team?

Excellent

Good

Fair

Poor

Comments

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Do you know how to use the hoist and what to do if any issues with the hoist?

Excellent

Good

Fair

Poor

Comments

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Do you know where to find the Key safe Code?

Excellent

Good

Fair

Poor

Comments

How was your overall experience on your First Day of Shadowing?

Did you feel supported from the office and from your Colleagues? If no, please explain why

Is there anything Nema Home Care Ltd can improve on?

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Information Below

EMPLOYEE OBSERVATION

Copyright 2025 © All rights Reserved. Design by Razurpenet

Fill Out the Information Below

Care Worker Shadow Form

EMPLOYEE OBSERVATION

Copyright 2025 © All rights Reserved. Design by Razurpenet

Fill Out the
Information Below