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Form – Missed Clock In/Out Times
Shaun
2020-05-20T11:24:11-04:00
Please enter your missed time information below.
Missed or Incorrect Punches
Caregiver Name
*
In which HomeCentris office do you work?
*
Owings Mills, MD
Gaithersburg, MD
Lanham, MD
Frederick, MD
Salisbury, MD
Harrisburg, PA
Philadelphia, PA
Fairfax, VA
WARNING:
ALERT MARYLAND CAREGIVERS: NEW AS OF 2/1/22: As you were notified, the state of Maryland and HomeCentris policy requires caregivers to record their time accurately and on time. For any missed punches or inaccurate punches in excess Maryland's allowable limit (four per month), the Company does not receive any compensation on your inaccurate punches. Therefore, on a caregiver's inaccurate or missing punches in excess of four per month, HomeCentris shall adjust employees time to match the hours reimbursed by Maryland which may exclude hours on inaccurate or missing punches. https://www.homecentris.com/frequent-clock-in-clock-out-mistakes/
What phone number did you dial to log your time?
*
ISAS: (855) 463-4727
MEDsys: (877) 895-5183
Date of Missed or Incorrect Punch
*
Missed or Corrected "Time In":
12
1
2
3
4
5
6
7
8
9
10
11
:
00
05
10
15
20
25
30
35
40
45
50
55
AM
PM
Missed or Corrected "Time Out":
12
1
2
3
4
5
6
7
8
9
10
11
:
00
05
10
15
20
25
30
35
40
45
50
55
AM
PM
Reason for Missed or Incorrect Punch
*
Forgot
Lost or Broken OTP
System did not accept call or call incomplete
Phone problem or poor cell coverage
Client emergency
Clock-in system outage
In community with client
Need more training
Reason for Missed or Incorrect Punch
*
Forgot
Phone problem or poor cell coverage
Client emergency
Need more training
CAREGIVER SIGNATURE: By signing below, I certify the above information is correct and understand any missed punch may be counted as a mistake for the month. I understand that repeated missed punches may lead to disciplinary action, including termination.
*
Clear
RESPONSIBLE PARTY SIGNATURE: By signing below, I certify the above information is correct.
*
Clear
If you are human, leave this field blank.
Submit
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