Georgia · Template guide · Updated October 20, 2026
Georgia Home Care Policies and Procedures Template: How to Fill It In
What a Georgia template should already contain, the choices you make in the brackets, and how to adopt it the way Rule 111-8-65 expects.
What our Georgia template fills in for you
These come straight from Rule 111-8-65, so you don’t change them. You can only make them stricter.
| Already written in | Georgia rule |
|---|---|
| Service agreement by the second visit or within 7 calendar days | Rule .09(2) |
| Service plan within 7 working days, reviewed at each supervisory visit | Rule .11 |
| Supervisory visits every 92 days (personal care) and 122 days (companion/sitter) | Rule .10(2) |
| Orientation before client contact; 8 clock hours of training a year after year one | Rule .09(6) |
| 40-hour personal care aide training path under RN direction | Rule .09(5) |
| Client records and complaint/incident files kept at least 5 years | Rule .09(4) |
| Written notice of the 10 client rights and the complaint phone number | Rule .12 |
| Fingerprint checks through GCHEXS | Chapter 111-8-12 |
The choices you fill in
Search the Word file for every [ bracket. These are the ones agencies most often ask about, with the template’s suggested value:
| Bracket in the template | What to decide | Georgia note |
|---|---|---|
| [AGENCY NAME], [PHONE] | Your legal or trade name and main number | Use Find and Replace; there are over 100 instances |
| Service area [LIST] | Counties or cities you serve | Only list areas where you can still meet the 92/122-day visit schedule |
| Visit cancellation [24] hours | Notice you ask clients to give | Agency choice; put the same number in your service agreement |
| Payment due within [__] days | Your billing terms | The service agreement must state charges (Rule .09(2)) |
| Full reassessment [annually] | How often you redo the in-home assessment | Separate from the required supervisory visits |
| Background lookback [7] years | Extra checks beyond GCHEXS | GCHEXS is required; the extra lookback is your choice |
| Personnel records [at least 5 years after employment ends] | Personnel file retention | The rules we reviewed set 5 years for client records; keeping personnel files 5 years too is a safe default |
| Discharge summary within [7] days | How fast you close out a discharged client | Chapter 111-8-65 sets no discharge-notice period; this is best practice |
| Governing body meets [Quarterly] | How often owners review operations | Rule .04 requires a governing body; frequency is your choice |
| QI summary [annually] | How often QI results go to the governing body | A quality improvement program is required (Rule .10(4)) |
Check these before you adopt it
The Georgia supplement in our manual lists what we couldn’t confirm from the rule text. Check these yourself:
- The exact mandated-reporter list and reporting deadline under O.C.G.A. 30-5-4
- GCHEXS deadlines and conditional-employment rules under Chapter 111-8-12
- The administrator training hours referenced in Rule .09(3)
- Current license fees and application forms on the DCH HFRD page
- The DCH address and phone numbers you print for clients
Adopt it the way Georgia expects
- Finish the brackets and delete services you don’t offer, then update the table of contents.
- Have an attorney or consultant review it.
- Have your governing body sign the adoption page. Rule .04 makes the governing body responsible for all policies and procedures.
- Train staff on it at orientation and keep signed acknowledgments (Form F-01).
- Start using the forms with your first client. Surveyors look at records, not just the binder.
Next: what DCH checks in your PHCP policy manual and when, or the rule-by-rule list in Georgia private home care provider policies and procedures.
Template ready to fill in
Georgia Home Care Policy and Procedure Manual
The editable Word template described on this page: 106 pages, 15 sections, 17 forms and the Rule 111-8-65 crosswalk. $79, instant download.
FAQ
Can I use a national home care template in Georgia?
You can start from one, but you’ll have to rewrite the Georgia values above. Generic templates usually use different supervision and training numbers.
Is the template in Word?
Yes. It’s an editable Word document plus a PDF, and it also opens in Google Docs.
How long does it take to fill in?
Most of the work is the bracket search and deleting services you don’t offer. Plan on time for review by an attorney or consultant before adoption.
Do I need to send the template to DCH?
We didn’t find a step where DCH reviews a template before you apply. You attest that your policies are in place, and surveyors check them later.
Sources
- Ga. Comp. R. & Regs. Chapter 111-8-65 (official chapter index)
- Rule 111-8-65-.04 Governing Body (Cornell LII)
- Rule 111-8-65-.09 Administration and Organization (Cornell LII)
- Rule 111-8-65-.10 Services (Cornell LII)
- Rule 111-8-65-.11 Service Plans (Cornell LII)
- Rule 111-8-65-.12 Client Rights, Responsibilities and Complaints (Cornell LII)
- Georgia DCH, Private Home Care Program (HFRD)
- Georgia DCH, Private Home Care Provider Application Checklist
- Georgia DCH, GCHEXS fingerprint background checks
This page summarizes Georgia rules and DCH materials as reviewed on October 19–20, 2026 and is not legal advice. Rules and agency procedures change; confirm current requirements with the Georgia Department of Community Health.