Office Information

Office Hours Monday through Friday 8:30am To Friday 5:00pm
Mail: 1467 Hark A way Rd, Chester Springs, PA 19425

  • Phone #: 610-453-5005
  • Email:
  • Fax #: 610-827-1135
  • Web site:
  • Emergency Line 610-453-5005 or CALL 911
  • If you are having an emergency (during business hours) 610-453-5005

Emergency Line 911

After hour if you are having a true emergency after business hours or if you need to call off of your shift for that evening or the next day, please the emergency number of 610-453-5005 Please be courteous and call at reasonable times No calls between 11pm and 5:45 am, unless it is a true emergency. Behavioral follow the instructions in the plan.

About Home Community Based Services:

We are an approved Provider by the Department of Public Welfare in the Commonwealth of Pennsylvania, Qualified by the Office of Developmental Programs (ODP), Office of Long-Term Living (OLTL), Bureau of Autism (BAS) and by Chester County Base Waiver Program.  We are subjected to 55 PA Code 51 and 52 rules and regulations. Provider Qualifications and verification Requirements are continuingly being updated.  We also are governed by Federal, State and Local requirements.  Home Community Based Services must meet applicable waiver amendments have valid MA provider agreements and be monitored by Departments on a regular bases but guaranteed every 2 years.   Our licensure and certification as an agency providing Home & Community Services is the key to our success.

Dear Caregiver Associate:

Welcome to the Home Community Based Servies family- we are delighted that you have decided to join our team!  Our mission is to help individuals with special needs at home for as long as possible by providing dependable and professional care.  Your new role will be pivotal in helping us achieve this mission. Your role here at Home Community Based Services will not only directly help your clients, but will provide much needed assistance to their families as well.  We believe you will find this opportunity very satisfying and rewarding and we will do everything we can to support you.  This handbook contains all of our policies and some of your training materials.  It is important that you familiarize yourself with all the information presented here before beginning service with a client.  If you still have materials to submit as condition of your employment; please note that we cannot assign you to a client until those documents have been place in your personnel file.  You can locate the necessary document on our web site under the employment tab on the web site

Organization Description

What We Do: Home and Community Base Services

We specialize in providing professional in-home care for individuals with special needs and who are not ready to leave their home for an assisted living facility or nursing home.  We provide our clients with companionship, personal care, respite, supported employment, behavioral therapy, community inclusion, integration and habilitation services.  These services provide social interaction to reduce isolation and improve the quality of their life. Our certified behavioral analyst (BCBA) enhances the development, abilities and choices for individuals with different kinds of disabilities.  They individualized ranges of intensive therapeutic/clinical services to address specific behavioral concerns.  Some of our main services include companionship, light housekeeping, laundry, meal planning and preparation, incidental transportation, errand running, ADL activities of daily living such as: personal hygiene and grooming assistance.

Who needs our services?

As the population begins to age out of school and getting older, there are more and more people every day that can benefit from our services.  Most people don’t understand that there is an alternative to moving out of their home into an assisted living facility, nursing home or some other institution.  In fact, most people want to remain at home for as long as possible-we can help!

Our Vision

Our vision is to be the world’s best and successful home based community services Company, setting a new standard of care and customer service for our industry.

Our Mission

Our mission is to ensure a better quality of life for our clients and their families, by providing dependable and affordable care.  We are a trusted and respected organization that takes a responsible role in supporting our clients and their families, our employees, and our community.

Client Relations

Our main focus is to provide truly outstanding service to our clients.  Your contact with clients, their families, and professionals in the community is a reflection of our entire company.

Home care is a very personal business that focuses on service, not things.  If those services are completed on time and with a smile, the client is going to feel like they have received good service.  We want all of our caregivers to have a fresh approach with each of their clients.  Home Community Based Services caregivers can solve problems and keep a positive attitude on even a bad day.


The Client Bill of Rights

As a client of Home Community Based Services, you have the right to:

  • Be fully informed of all your rights and responsibilities.
  • Be informed about the plan for services and be involved in the development of the plan.
  • Be advised of any change in the services before the change is made.
  • Accept or refuse services.
  • Be fully informed of company policies and changes for services, including eligibility for third party reimbursements.
  • Be informed of the contact numbers of supervisory personnel.
  • Be informed of complaint procedures.
  • Privacy, including confidential treatment of records and to refuse release of records to any individual outside the company except in the case of the client’s transfer to be a health care facility, or as required by law or third party payment contracts.
  • Have property and residence treated with respect.
  • Receive a timely response from the company to your request for service.
  • Written notice of the contact information for the state licensing authority.
  • Responsibility of the client and or responsible party to inform the provider of any change in the client’s condition.
  • Voice grievances and suggest changes in service or staff without fear of recrimination or discrimination.
  • Be informed of what to do in the event of an emergency.

Your responsibilities:

  • Inform the office of any major changes in your health status or condition.
  • Cooperate with personnel without discrimination, as to color, religion, sex, national or ethnic origin.
  • Make a family member or substitute available, who will assume a primary caregiver role when staff is not in your home.
  • Give relevant information to Home Community Based Services about your care needs.
  • Build mutual trust and cooperation with your caregiver.

Equal Employment Opportunity

In order to provide equal employment and advancement opportunities to all individuals, employment decisions at Home Community Based Services will be based on merit, qualifications, and abilities. Community Based Services does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, or any other characteristic protected by law.  This policy governs all aspects of employment, including selection, job assignment, compensation, discipline, termination, and access to benefits.  Any caregivers with questions or concerns about any type of discrimination in the workplace are encouraged to bring these issues to the attention of their immediate supervisor of the owner.  Caregivers can raise concerns and make reports without fear of reprisal.  Anyone found to be engaging in any type of unlawful discrimination will be subject to disciplinary action, up to and including termination of employment.

Discrimination Policy

We do not discriminate on the basis of race, color, national origin, religious creed, ancestry, sex, age or disability, as used in Title VI and Title VII of the Civil rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, The Age of Discrimination Act of 1975, Americans With Disabilities Act of 1990 and/or the Pennsylvania Human Relations Act of 1955, as amended. Reasonable accommodations will be provided for handicapped employees. Complaints can be written and filed with the Office of Equal Opportunity    phone #: 1800-669-4000, Pennsylvania Department of Health 717-783-1379, and/or the Pennsylvania Human Relations Commission 717-787-4410 717-787-4087 TTY.

Employment Applications

Home Community Based Services receives applications through its web site and all necessary documentation is outlined under the employment tab.

Employment Reference Checks

To ensure that individuals who join Home Community Based Services are well qualified and have a strong potential to be productive and successful, it is the policy to check the employment references of all applicants. Applicants are screened prior to hire and on an ongoing monthly basis after hire if excluded from participation in Medicare, Medicaid or another federal health care program (LEIE, SAM, EPLS, DPW Medicheck list). Motor vehicle record checks to be conducted, current vehicle registration along with current auto insurance must be in staff file.  PPD tests (TB test) every year as outlined by CMS Bulletins and OSHA directors. Criminal Record investigations are required every 2 years.  FBI fingerprints are conducted for everyone even if a state resident over 2 years. Child Abuse reports even if not working with a client less than 18 years of age.  We will evaluate background information consistently, according to non-discriminatory criteria.  These evaluations may result in disqualification for consideration for employment at Home Community Based Services. In addition, any falsification or omission of information on any application form (including the background authorization, medical or drug authorization screening, and the employment application form) may disqualify the applicant from consideration. Social Security validation is performed with each new hire through the website

Business Ethics & Conduct

Home Community Based Services’ reputation is built upon the principles of fair dealing and ethical conduct of our caregivers.  Our reputation for providing excellent customer experience requires stringent adherence to federal, local and state laws, as well as the ethical conduct of our staff and caregivers.  The continued success of Home Community Based Services is dependent upon our clients’ trust and we are dedicated to preserving that trust.  If a situation arises where it is difficult to determine the proper course of action, the matter should be discussed openly with your immediate supervisor and, if necessary, with the owner for advice and consultation.

Compliance with this policy of business ethics and conduct is the responsibility of every Home Community Based Services caregiver.

Record Access and Retention

Provider records are retained pertaining to the Government Auditing Standards (GAGAS), also known as the Yellow Book. In our instance we are subject to OMB Circular A-133 (Single Audit); Title 45, CFR 74.26 (federal guidance regarding audit requirements of for-profit entities) and any other federal requirements. Therefore, we have electronic records and paper records and keep for 7 years per United States Internal Revenue requirements. Chapter 51.15.

Immigration Law Compliance

Home Community Based Services is committed to employing only United States citizens and aliens who are aliens who are authorized to work in the United States and does not unlawfully discriminate on the bases of citizenship or national origin.  In compliance with the Immigration
Reform and Control Act of 1986, each new caregiver, as a condition of employment, must complete the Employment Eligibility Verification Form I-9 and present documentation establishing identity and employment eligibility.  Former caregivers who are rehired must also complete the form if they have not completed an I-9 with Home Community Based Services with the past three years, or if their previous I-9 no longer retained or valid.

Conflicts of Interest

The purpose of these guidelines is to provide general direction such that caregivers can seek further clarification on issues related to the subject of acceptable standards of operation. Contact the office for more information or questions about conflicts of interest.  A conflict of interest can occur when a caregiver is in a position to influence a decision that may result in a personal gain for that caregiver or for a relative as a result of Home Community Based Services business dealings.  For the purposes of this policy, a relative is any person who is related by blood or marriage, or whose relationship with the caregiver is similar to that of persons who are related by blood or marriage.  No “presumption of guilt” is created by the mere existence of a relationship with outside clients or care firms.  However, if caregivers have any influence on transactions involving care agreements, it is imperative that they disclose to the office as soon as possible.  Any and all time worked for the client must be put on time sheet.  Caregivers must notify the office if the client offers them gifts-monetary or otherwise.  Caregivers are specifically prohibited from making private arrangements with our or provide care independently to any client during their employment with Home Community Based Services and for one year after leaving the employment of Home Community Based Services. Any violation of this policy will result in the caregivers financial liability to Home Community Based Services in accordance with non-competition agreement signed at hire.  Minimum penalty is $1,000.


The protection of confidential business information and trade secrets is vital to the interest and the success of Home Community Based Services.  Such confidential information includes, but is not limited to, the following examples:

  • Pending services and proposals
  • Referral source list
  • Compensation data
  • Computer processes
  • Computer programs and codes
  • Client list
  • Client preferences
  • Financial information
  • Labor relations strategies
  • Marketing strategies

All caregivers are required to sign a non-disclosure agreement as a condition of their employment.  Caregivers who improperly use or disclose trade secrets or confidential business information will be subject to disciplinary action, up to and including termination of employment and legal action, even if they do not actually benefit from the disclosed information.

Disability Accommodation

Home Community Based Services is committed to complying fully with the Americans with Disabilities Act (ADA) and ensuring equal opportunity in employment for qualified persons with disabilities.  All employment practices and activities are conducted on a non-discriminatory basis.  Hiring procedures have been reviewed and provide persons with disabilities meaningful employment opportunities.  Pre-employment inquiries are made only regarding an applicant’s ability to perform the duties of the position.  Reasonable accommodation is available to all disabled caregivers, where their disability affects the performance of job functions. All employment decisions are based on the merits of the situation in accordance with defined criteria, not the disability of the individual.  Qualified individuals with disabilities are entitled to equal pay and other forms of compensation (or changes in compensation) as well as in job assignments, classifications, organizational structures, position descriptions, lines of progression and seniority lists. Leave of all types will be available to all eligible caregivers on an equal basis.  Home Community Based Services is also committed to not discriminating against any qualified caregivers or applicants because they are related to or associated with a person with a disability.  Home Community Based Services will follow any state or local law that provides individuals with disabilities greater protection that the ADA.  This policy is neither exhaustive nor exclusive. Home Community Based Services is committed to taking all other actions necessary to ensure equal employment opportunity for persons with disabilities in accordance with the ADA and all other applicable federal, state, and local laws.

Personal Data Changes

It is the responsibility of each caregiver to promptly notify Home Community Based Services of any changes in personal data.  Personal mailing addresses, telephone numbers, number and names of dependents, individuals to be contacted in the event of emergency, educational accomplishments, and other such status reports should be accurate and current at all times.  If any personnel data has changed, notify the office.

Employment Termination

Termination of employment is an inevitable part of personnel activity within any organization, and many of the reasons for termination are routine.  Below are examples of some of the most common circumstances under which employment is terminated:

  • Resignation- voluntary employment termination initiated by a caregiver
  • Discharge- involuntary employment termination initiated by the company. Since employment with Home Community Based Services is based on mutual consent, both the caregiver and Home Community Based Services have the right to terminate employment at will, with or without cause, at any time.  Caregivers will receive their final pay in accordance with applicable state law.

Pay Corrections

Home Community Based Services takes all reasonable steps to ensure that caregivers receive the correct amount of pay in each paycheck and that caregivers are paid promptly on the scheduled payday.  In the unlikely event that there is an error in the amount of pay, the caregiver should promptly bring the discrepancy to the attention of the office so that corrections can be made as quickly as possible.

Caregiver Conduct and Work Rules

To provide the best possible work environment, Home Community Based Services expects caregiver to follow rules of conduct that will protect the interest and safety of clients, caregiver, and the company.  It is not possible to list all the forms of behavior that are considered unacceptable in the workplace.  The following are examples of infractions of rules of conduct that may result in disciplinary action, up to and including termination of employment:

  • Theft or inappropriate removal or possession of property
  • Falsification of timekeeping records
  • Working under the influence of alcohol or illegal drugs
  • Possession, distribution, sale, transfer, or use of alcohol or illegal drugs in the workplace, while on duty, or while operating employer-owned vehicles or equipment.
  • Fighting or threatening violence in the workplace
  • Boisterous or disruptive activity in the workplace
  • Negligence or improper conduct, leading to damage of employer-owned or customer-owned property
  • Insubordination or other disrespectful conduct
  • Violation of safety or health rules
  • Smoking in prohibited areas
  • Sexual or other unlawful or unwelcome harassment
  • Possession of dangerous or unauthorized materials, such as explosives or firearms, in the work place
  • Excessive absenteeism or any absence without notice
  • Unauthorized absence from work station during the workday
  • Unauthorized use of telephones, mail system, or other employer-owned equipment
  • Unauthorized disclosure of business “secrets” or confidential information
  • Violation of personnel policies
  • Unsatisfactory performance or conduct

Employment with Home Community Based Services is at the mutual consent of Home Community Based Services and the caregiver, and either party may terminate that relationship at any time, with or without cause, and with or without advance notice.

Drug Testing

Home Community Based Services is committed to providing a safe, efficient, and productive work environment for all caregivers.  Using or being under the influence of drugs or alcohol on the job may pose serious safety and health risks.  The unlawful manufacturing, distribution, dispensation, possession or use of a controlled substance is strictly prohibited in our workplace.  Caregivers who violate this policy will be subject to discipline up to and including termination of employment.  To help ensure a safe and healthful working environment, caregivers may be asked to provide body substance samples (such as urine and/or blood) to determine the illicit or illegal use of drugs and alcohol.  Refusal to submit to drug testing may result in disciplinary action, up to and including termination of employment.  Questions concerning this policy or its administration should be directed to the office.

Sexual & Other Unlawful Harassment

Home Community Based Services is committed to providing a work environment that is free from all forms of discrimination and conduct that can be considered harassing, coercive, or disruptive, including sexual harassment.  Actions, words, jokes, or comments based on an individual’s sex, race, color, national origin, age, religion, disability, sexual orientation, or any other legally protected characteristic will not be tolerated. Sexual harassment is defined as unwanted sexual advances, or visual, verbal, or physical conduct of a sexual nature.  This definition includes many forms of offensive behavior and includes gender-based harassment of a person of the same sex as the harasser. The following is a partial list of sexual harassment examples:

  • Unwanted sexual advances.
  • Offering employment benefits in exchange for sexual favors.
  • Making or threatening reprisals after a negative response to sexual advances.
  • Visual conduct that includes leering, making sexual gestures, or displaying of sexually suggestive objects or pictures, cartoons or posters.
  • Verbal conduct that includes making or using derogatory comments, epithets, slurs, or jokes.
  • Verbal sexual advances or propositions.
  • Verbal abuse of a sexual nature, graphic verbal commentaries about an individual’s body, sexually degrading words used to describe an individual, or suggestive or obscene letters, notes, or invitations.
  • Physical conduct that includes touching, assaulting, or impeding or blocking movements.

Unwelcome sexual advances (either verbal or physical), requests for sexual favors, and other verbal or physical conduct of a sexual nature constitute sexual harassment when:

  • Submission to such conduct is made either explicitly or implicitly a term or condition of employment
  • Submission or rejection of the conduct is used as a basis for making employment decisions
  • The conduct has the purpose or effect of interfering with work performance or creating a intimidating, hostile, or offensive work environment.

If you experience or witness sexual or other unlawful harassment in the workplace, report it immediately to your supervisor.  If the supervisor is unavailable or you believe it would be inappropriate to contact that person, you should immediately contact the office.  You can raise concerns and make reports without fear of reprisal or retaliation.  All allegations of sexual harassment will be quickly and discreetly investigated.  To the extent possible, your confidentiality and that of any witnesses and the alleged harasser will be protected against unnecessary disclosure.  When the investigation is completed, you will be informed of the outcome of the investigation.  Any caregiver who becomes aware of possible sexual or other unlawful harassment must immediately advise the office so it can be investigated in a timely and confidential manner.  Anyone engaging in sexual or other unlawful harassment will be subject to disciplinary action, up to and including termination of employment.


Progressive Discipline

The purpose of this policy is to state Home Community Based Services position on administering equitable and consistent discipline for unsatisfactory conduct in the workplace.  The best disciplinary measure is the one that does not have to be enforced and comes from good leadership and fair supervision at all employment levels.  Home Community Based Services’ own best interest lies in ensuring fair treatment of all caregivers and in making certain that disciplinary actions are prompt, uniform, and impartial.  The major purpose of any disciplinary action is to correct the problem, prevent recurrence, and prepare the caregiver for satisfactory services in the future.  Although employment with Home Community Based Services is based on mutual consent and both the caregiver and Home Community Based Services have the right to terminate employment at will, with or without cause or advance notice, Home Community Based Services may use progressive discipline at its discretion. Disciplinary action may call for any of four steps- verbal warning, written warning, suspension with our without pay, or termination of employment-depending on the severity of the problem and the number of occurrences.  There may be circumstances when one or more steps are bypassed.  Progressive discipline means that, with respect to most disciplinary problems, these steps will normally be followed:

  • A first offense may call for a verbal warning
  • A second offense may be followed by a written warning
  • A third offense may lead to a suspension
  • A Forth offense may then lead to termination of employment


Having qualified and well trained staff is the key component of Home Community Based Services being successful. Therefore we offer annual trainings required by the Department of Human Services.  Meetings will be offered approximately four times during the fiscal year. The material presented will be based off the required training elements. Certain topics can be fulfilled by other agencies, but proof of training is required by the state.  These topics are (1) Department policy on intellectual disability principles and values, (2) Identification and prevention of abuse, neglect, and exploitation of an individual and (3) Accurate billing and documentation of service delivery.  A certificate must be submitted with participants name, topic, dates of training and agency that provided the training. The other topics required by the department of human services will be covered at the annual meeting.

Back Up Plan

In addition to assign staff to client each consumer via designated staff should assist in providing training and sourcing out to make sure that there is a team (4-5) staff members per client so that there is if needed  back up staff to cover if need arises. With parent/legal guardian assistance creates an individualized back-up plan.  An Individualized back-up plan should clearly outline the steps to be taken in the event that routine services are not able to be delivered.  Based on the client’s preferences and choice, strategies may include, but are not limited to the use of family, neighbors and friends of the client’s choice, and/or agency staff. As part of the back-up development process, the client are responsible for ensuring that the back-up plan incorporates an emergency back-up plan for serious emergencies that might causes a disruption in routine services being delivered to the client for an extended period of time.  Examples of what might cause a disruption in routine services being delivered for extended periods of time might include severe storms, floods, or any type of community-wide disaster.  A plan for these types of scenarios must be addressed.


No alcoholic beverages are allowed at any Home Community Based Services training or job assignments.  Additionally, no smoking is allowed at any client’s venue or inside the Office.   Everyone’s cooperation with these important health and safety requirements is greatly appreciated.

It is the intent Home Community Based Services that a strict alcohol prohibition be observed by all people associated with any activities or events which involves our clients.  Offenders of the alcohol policy will immediately be sent home from the event and will be suspended for a minimum of one year; additionally, a $500 fine may be levied on the individual.  Please realize that these measures are taken to emphasize the importance of everyone’s role in the safety of Home Community Based Services’ participants.

Since it is impossible to describe every circumstance that might arise, it is expected that each individual, where necessary, will exercise responsible and prudent judgment, keeping in mind the basic intent of this policy.


For the safety of all participants, Home Community Based Services prohibits any staff member or volunteer (excluding spouses of participates) from dating or having a sexual relationship with any Home Community Based Services participate. In the event that Home Community Based Services learns of any dating or sexual relationship, the organization immediately shall require either: i) that the staff member or volunteer end his or her association with Home Community Based Services; or ii) that the association between the staff member or volunteer and Home Community Based Services will be terminated.

In the case of a Home Community Based Services client who is also a staff member or volunteer, the Chief Executive Officer of the organization where the client participates must evaluate the circumstance on a case-by-case basis and determine if an authority relationship exists between the staff/volunteer employee and the participate, and if it is determined that there is such a relationship, then apply the above policy in the same manner as the policy is applied to non- Home Community Based Services staff or volunteers.

Home Community Based Services respects the rights of clients to have the full range of human relationships available to other human beings. This policy shall not be interpreted as a limitation on the rights of clients, but only as a restriction on Home Community Based Services staff and volunteers.

Use of 15-Passenger Vans

C-op provider Programs are prohibited from using 15-passenger vans to transport clients or other individuals to and from our arranged events.

Transporting Injured/Sick Persons from Home Community Based Services Events to the Hospital

If an injured or sick person needs medical treatment as a result of an injury sustained or becoming sick during an event, it is the recommendation of Home Community Based Services that transportation of the injured or sick person be handled by a professional ambulance service.

Volunteer/staff medical personnel are available during organized events.  When you arrive at the location of the occasion for which you are volunteering/staffing, make note of where medical volunteers/staff are located or how they can be reached.  If a participate, staff, spectator, or volunteer becomes sick or injured at an event, do not attempt to move or treat him or her.  Rather, contact the nearest medical personnel immediately.  If you are unable to contact on-site medical personnel, contact 9-1-1 for emergency medical services.

Consumers Participation Forms

Current client participation forms are required for all while attending an event.  Staff must know the valid client participation form for each client under their supervision at all times.  In addition, staff is asked to become familiar with the medical history of any client for whom s/he is responsible.


All staff is required to give two week notice of vacation so ample time is to find substitute staff for adequate time to find for client.

Restrain Policy

Our agency policy is positive practices and person-centered emphasizing learning and teaching alternative behavioral within a positive framework rather than using a negative consequences or punishment to stop behaviors that are undesirable or dangerous. All staff members are knowledgeable about the use of positive practices specific to the individual they support and demonstrate them when needed. Every attempt shall be made to anticipate and de-escalate the behavior using methods of intervention written in the behavioral plan.  In accordance of MR Bulletin #00-06-09 Emergency situations in which the client’s behavior is life-threatening or otherwise extremely violent staff observing the behavioral are required to take immediate, appropriate action to  protect the health and safety of an individual and only then.  Home Community Based Services does not use any forms of seclusion.

Reporting Incidents

It is important to report all incidents during the event to ensure that they are handled properly and that sufficient follow-up is conducted.  Following is a summary of the reporting process and the incident report form which should be completed.  Home Community Based Services will be responsible for forwarding all incident reports to the insurance company.

Any medical personnel assisting with an incident should not fill out the form or receive it.  Someone such as the staff or guardian should complete the form and it should then be collected by proper staff authority.  Blank copies will be available on the web site

Reporting an Incident or Claim for Staff


It is important that an incident report form be completed as promptly and accurately as possible.  This allows the claims process to be initiated as quickly as possible and it also provides a great deal of risk management information to be used in an effort to identify sources of loss and potential ways of eliminating future loss.

Please note the procedures to follow when reporting a Home Community Based Services Corporate Insurance Program incident.


The First Report of Accident/Incident Form should be completed phoned and mailed/faxed/emailed to the insurance claim service to report accidents involving clients, staff, and volunteers, as well as incidents involving injury to spectators, other people or damaged property.

The First Report of Accident/Incident Form should be completed every time there is an accident involving one of the above specified individuals.  It does not matter that the accident results in minor or no injury but that an accident/incident did happen.  Capturing this information helps focus in on problem areas.

Examples of accidents or incidents involving spectators, others or damage to property may include, but are not limited to:

  • potential liability
  • property damage
  • allegation
  • threat of any kind

It is important that the report be completed as promptly as possible.  Always include names of any witnesses and a brief description of the actual incident.

Reporting an Incident

Each completed report should be sent to Home Community Based Services Insurance Services.  The address is located at the bottom of the form.

In the event of serious injury, one requiring transportation to a hospital or to an emergency care facility, hospitalization or fatality, an immediate telephone call should be made to the claims service: Insurance Carrier The number is (888-388-7943). Police number 05685765 This number is attended 24 hours a day, 7 days a week.  In addition, call the Home Community Based Services office at (610) 543-5005 and leave a voicemail message about the incident.


Notification of a Claim

Insurance carrier will respond to each incident report as appropriate.  In the event of injury to a staff, or volunteer, a claim form will be forwarded directly to the individual that sustained an injury.  If the injured person is under the age of 18, it will be forwarded to the parent or guardian.  In the case of an injury to a client, the form will be forwarded to the parent, guardian, or care provider indicated on the form.  Insurance company will follow up each claim form at two weeks and again at four weeks if no response has been received from the person to whom the claim form was mailed.

For each claim form sent out, a copy of the correspondence will also be forwarded to the Home Community Based Services office.  Furthermore, the insurance carrier will send the Home Community Based Services office a copy of each follow up correspondence.  If no response is received, Insurance carrier may ask the Home Community Based Services office to assist in making contact.  The file will be closed if there is no activity to report.

Reporting an Incident or Claim for Client


Critical Incident Management Policy-

The prevention, reporting, notification, investigation and management of critical incidents:

Reporting the incident: The following are categories of incidents to be reported using a standardized incident report that is located on the web site under documents comprised of two components, the first section and the final section. For these incident categories, the first section must be submitted within 24 hours of the occurrence or discovery of the incident.

The first section of the incident report includes individual and provider demographics, incident categorization, actions taken to protect the health and safety of the individual, and a description of the incident. The final section of the Incident report must be submitted through HCSIS within 30 days of the incident’s recognition or discovery, and must contain all of the information from the first section as well as additional specific information relevant to the incident. If the provider agency determines they will not be able to meet the 30-day reporting timeframes for completion of the final section, notification of an extension is to be made to the AE and the ODP regional office by means of HCSIS prior to the expiration of the 30-day period.

*Abuse. – The allegation or actual occurrence of the infliction of injury, unreasonable confinement, intimidation, punishment, mental anguish, sexual abuse or exploitation. Abuse is reported on from the victim’s perspective, not on the person committing the abuse. This includes physical abuse, psychological abuse, sexual abuse, verbal abuse, and improper or unauthorized use of restraint. Physical abuse is defined as an intentional physical act by staff or other person which causes or may cause physical injury to an individual, such as striking or kicking, applying noxious or potentially harmful substances or conditions to an individual. Psychological abuse is an act, other than verbal, which may inflict emotional harm, invoke fear and/or humiliate, intimidate, degrade or demean an individual. Sexual abuse is an act or attempted acts such as rape, incest, sexual molestation, sexual exploitation or sexual harassment and inappropriate or unwanted touching of an individual by another. Any sexual contact between a staff person and an individual is abuse. Verbal abuse involves verbalizations that inflict or may inflict emotional harm, invoke fear and/or humiliate, intimidate, degrade or demean an individual. Improper or unauthorized use of restraint is a restraint not approved in the individual support plan or one that is not a part of an agency’s emergency restraint procedure is considered unauthorized. A restraint that is intentionally applied incorrectly is considered an improper use of restraint.

*Death. – All deaths are reportable.

*Disease Reportable to the Department of Health – An occurrence of a disease on The Pennsylvania Department of Health List of Reportable Diseases. The current list can be found at the Department of Health’s website, An incident report is required only when the reportable disease is initially diagnosed.

*Emergency closure. – An unplanned situation that results in the closure of a home or program facility for one or more days. This category does not apply to individuals who reside in their own home or the home of a family member. (This may be reported as a site report.)

*Emergency room visit. – The use of a hospital emergency room. This includes situations that are clearly “emergencies” as well as those when an individual is directed to an emergency room in lieu of a visit to the Primary Care Physician (PCP) or as the result of a visit to the PCP. The use of an emergency room by an individual’s PCP, in place of the physician’s office, is not reportable.

*Fire. – A situation that requires the active involvement of fire personnel, i.e. extinguishing a fire, clearing smoke from the premises, responding to a false alarm, and the like. Situations which

require the evacuation of a facility in response to suspected or actual gas leaks and/or carbon monoxide alarms, or both, are reportable. Situations in which staff extinguishes small fires without the involvement of fire personnel are reportable. This may be reported as a site report.

*Hospitalization. – An inpatient admission to an acute care facility for purposes of treatment. Scheduled treatment of medical conditions on an outpatient basis is not reportable.

*Individual-to-individual abuse. – An interaction between one individual receiving services and another individual receiving services resulting in an allegation or actual occurrence of the infliction of injury, unreasonable confinement, intimidation, punishment, mental anguish, sexual abuse or exploitation. Individual Abuse is reported on from the victim’s perspective, not on the person committing the abuse.

*Injury requiring treatment beyond first aid. – Any injury that requires the provision of medical treatment beyond that traditionally considered first aid. First aid includes assessing a condition, cleaning an injury, applying topical medications, applying a Band-Aid, and the like. Treatment beyond first aid includes but is not limited to lifesaving interventions such as CPR or use of the Heimlich maneuver, wound closure by a medical professional, casting or otherwise immobilizing a limb. Evaluation/assessment of an injury by

Emergency personnel in response to a “911” call is reportable even if the individual is not transported to an emergency room.

*Law enforcement activity. – The involvement of law enforcement personnel is reportable in the following situations:

(i) An individual is charged with a crime or is the subject of a police investigation

which that may lead to criminal charges.

(ii) An individual is the victim of a crime, including crimes against the person or their property.

(iii) A crime such as vandalism, or break-in that occurs at a provider site. This may be reported as a site report.

(iv) An on-duty employee or an employee who is volunteering during off duty time, who is charged with an offense, a crime or is the subject of an investigation while on duty or volunteering. This is reported as a site report.

(v) A volunteer who is charged with an offense, a crime or is the subject of an investigation resulting from actions or behaviors that occurred while volunteering. This is reported as a site report.

(vi) A crisis intervention involving police/law enforcement personnel.

(vii) A citation given to an agency staff person for a moving violation while operating an agency vehicle, or while transporting individuals in a private vehicle, is reported as a site report.

*Missing person.– A person is considered missing when they are out of contact with staff for more than 24 hours without prior arrangement or if they are in immediate jeopardy when missing for any period of time. A person may be considered in “immediate jeopardy” based on the person’s personal history and may be considered “missing” before 24 hours elapse. Additionally, it is considered a reportable incident whenever the police are contacted about an individual and/or the police independently find and return

the individual, or both, regardless of the amount of time the person was missing.

*Misuse of funds– An intentional act or course of conduct, which results in the loss or misuse of an individual’s money or personal property. Requiring an individual to pay for an item or service that is normally provided as part of the individual support plan is considered financial exploitation and is reportable as a misuse of funds. Requiring an individual to pay for items that are intended for

use by several individuals is also considered financial exploitation. Individuals may voluntarily make joint purchases with other individuals of items that benefit the household.

*Neglect. – The failure to obtain or provide the needed services and supports defined as necessary or otherwise required by law or regulation. This includes the failure to provide needed care such as shelter, food, clothing, personal hygiene, medical care, protection from health and safety hazards, attention and supervision, including leaving individuals unattended and other basic treatment and

necessities needed for development of physical, intellectual and emotional capacity and well being. This includes acts that are intentional or unintentional regardless of the obvious occurrence of harm.

*Psychiatric hospitalization. – An inpatient admission to a psychiatric facility, including crisis facilities and the psychiatric departments of acute care hospitals, for the purpose of evaluation and/or treatment, or both, whether voluntary or involuntary. This includes admissions for “23 hour” observation and those for the review and/or adjustment, or both, of medications prescribed for the treatment of psychiatric symptoms or for the control of challenging behaviors.

*Rights violation. – An act which is intended to improperly restrict or deny the human or civil rights of an individual including those rights which are specifically mandated under applicable regulations. Examples include but are not limited to, the unauthorized removal of personal property, refusal of access to the telephone, privacy violations, and breach of confidentiality. This does not include restrictions that are imposed by court order or consistent with a waiver of licensing regulations.

*Suicide attempt. – The intentional and voluntary attempt to take one’s own life. A suicide attempt is limited to the actual occurrence of an act and does not include suicidal threats.

The following incident categories are reported using standardized abbreviated HCSIS incident management data entry screens designed to gather relevant data about these incidents. Data must be input within 72 hours of the recognition or discovery of the event:

*Medication error – Any nonconforming practice with the “Rights of Medication Administration” as described in the ODP Medication Administration Training Course. This includes omission, wrong dose, wrong time, wrong person, wrong medication, wrong route, wrong position, wrong technique/method and wrong form.

*Restraints – Any physical, chemical or mechanical intervention used to control acute, episodic behavior that restricts the movement or function of the individual or portion of the individual’s body, including those that are approved as part of an individual support plan or those used on an emergency basis. Improper or unauthorized use of restraint is considered abuse and is to be reported under the abuse category.