Personal Care Agency Readiness Assessment Survey

This comprehensive survey is designed to help Personal Care Agencies assess their compliance with the new Maine Department of Health and Human Services Licensing Rule for PCAs. The Survey covers all key areas of the licensing requirements and helps identify areas where your agency may need additional support or improvement.

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* 1. Personal Care Agency Name:

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* 2. Personal Care Agency Address:

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* 3. Name of the Administrator:

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* 4. Phone

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* 6. Has your agency obtained a valid license from the Maine DHHS to operate as a Personal Care Agency?

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* 7. Does your agency exclusively provide personal care services and not any services requiring licensed medical professionals?

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* 8. Are personal care services provided only in client’s places of residence and not in prohibited settings?

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* 9. Is your agency's license current, non-expired, and correctly reflects the agency's name, address and type?

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* 10. Is your agency aware that licenses are non-assignable and non-transferable?

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* 11. Does your agency have a physical site in Maine that meets zoning requirements and ensures confidentiality?

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* 12. If operating from a private residence, is there a separate and secure space dedicated to agency operations?

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* 13. Does your agency have procedures to notify the DHHS of any changes (e.g, agency name, address, administrator) within the specified timeframes?

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