Personal Care Agency (PCA)- Wisconsin State Complete Licensure Package

Introducing our comprehensive Personal Care Agency (PCA) Licensure Document package designed specifically for Wisconsin State Licensure. We understand the critical importance of adhering to state regulations and maintaining the highest standards of care in the home health industry. Our meticulously crafted set of state-compliant documents is your key to achieving and sustaining compliance while delivering exceptional healthcare services.

Wisconsin PCA Licensing Checklist: PDF

Wisconsin PCA Application Letter: PDF

The Number of Documents

1. PCA Application Form
2. Plan of Operation
3. Statement of Services
4. Balance Sheet
5. Policies and Procedures

• Records and Required Notifications Policy and Procedures
• Personnel Management Policy and Procedures 
• Infection Control Policy - DHS 105.17(1r)
• Client Services Acceptance Policy - DHS 105.17(1w)(a)
• Client Rights 
• Service Agreement Policy- DHS 105.17(1w)(c)
• Client Records Policy- DHS 105.17(1w)(d)
• Discharge of a Client Policy- DHS 105.17(1w)(f)
• Complaint and Grievance Procedure - DHS 105.17(1w)(h)
• Quality Assessment and Assurance Policy 
• Policy and Job Description- Duties- RN Supervisor
• Qualifications and Duties- Personal Care Worker (PCW)
• Personal Care Services Policy and Procedures DHS 107.112(1)(B)1-13