Home Care Survey & Licensing Readiness Kit Bundle | 8 Editable Word Templates | Mock Survey, Audit Tools, Plan of Correction

Survey & Licensing Readiness Kit Bundle for U.S. non-medical home care agencies: 8 editable templates in one instant download.

Get ready for a state licensing survey, renewal or complaint visit with one matching set of self-review tools: run a mock survey, audit personnel and client files, organize your survey binder, and track deficiencies through a plan of correction.

WHAT'S INCLUDED (8 templates; 9 Word .docx files in one ZIP):

1. Mock Survey Master Checklist (6 pages, Word). File: Survey-Kit-01-Mock-Survey-Master-Checklist.docx
2. Personnel File Audit Tool (6 pages, Word). File: Survey-Kit-02-Personnel-File-Audit-Tool.docx
3. Client Record Audit Tool (6 pages, Word). File: Survey-Kit-03-Client-Record-Audit-Tool.docx
4. Survey Binder Index and Document Request Log (4 pages, Word). File: Survey-Kit-04-Survey-Binder-Index-Document-Request-Log.docx
5. Plan of Correction Template (3 pages, Word). File: Survey-Kit-05-Plan-of-Correction-Template.docx
6. Deficiency and Corrective Action Tracker (4 pages, Word). File: Survey-Kit-06-Deficiency-Corrective-Action-Tracker.docx
7. Annual Program Evaluation and Quarterly Record Review (4 pages, Word). File: Survey-Kit-07-Annual-Program-Evaluation-Quarterly-Record-Review.docx
8. Survey-Day Staff Prep and Entrance/Exit Conference Checklist (3 pages, Word). File: Survey-Kit-08-Survey-Day-Staff-Prep-Entrance-Exit-Checklist.docx

PLUS: Agency Instructions (Survey-Kit-00-Agency-Instructions.docx), a setup guide for the whole set. Remove before use.

WHO IT IS FOR:

• Agency owners and administrators getting ready for a state licensing survey
• Agencies preparing for license renewal or a complaint visit
• Quality and compliance leads running mock surveys and record audits
• New agencies setting up their first survey binder

HOW TO CUSTOMIZE:

1. Unzip the download and open each file in Microsoft Word.
2. Use Home > Replace > Replace All (Ctrl+H) to change [Agency Name] and [State] to your own details. This also reaches the page headers.
3. Fill in the blank lines with your own policies, contacts and choices, and check every state-specific item against your state rules.
4. Add your logo if you want one, save your master copies, and print or share as needed.

Some lines cross-reference policy numbers from a companion Policy & Procedure Manual (sold separately); edit them to match your own policies.

INSTANT DOWNLOAD: This is a digital product. No physical item will be shipped. After purchase, download the ZIP from your Payhip library or the link in your confirmation email. Works best in Microsoft Word; Google Docs and LibreOffice can open the files, but some layout may shift.

DISCLAIMER: These are customizable templates, not legal advice. Rules differ by state, so check each template against your state rules and have a qualified professional review it before use. Using these templates does not guarantee that your agency meets any law, licensing survey or standard. Not a license to operate and not state-approved. For personal and business use by the buyer; please do not resell or share the files.