Telephony Training Required Attendant Application Form Attendant EVV Training AcknowledgementAttendant Name* Please read and initial each statement, and sign at the bottom. Landline (Home Phone) Training1* I understand that if the Consumer's home phone is the required form of EVV to be used, I must utilize that phone to clock in and out for each shift worked.FOB Training2* I understand that if the Consumer does not have a landline telephone and the app cannot be utilized, the attendant’s cell phone will be used to clock in and out. When a cell phone is the determined form of EVV to be used, a FOB will be placed in the Consumer’s home.3* I understand that the FOB will be placed in the Consumer’s home by a Blue Skies Home Care, LLC, employee, and cannot be moved or removed by anyone other than a Blue Skies employee. Moving or removing the device will result in the attendant not being paid and the termination of the Consumer’s services with our company.App Training4* I understand if I do not utilize the lock screen on my smartphone, that I must log out of the app when not in use.5* I understand that I must contact my Consumer’s CDS Specialist immediately on the day which it occurs if I am unable to use the app for any reason.6* I understand it is my responsibility to ensure my location is on at all times when I am using the mobile app.7* I understand I must be inside the Consumer’s home when clocking in and out, unless providing approved transportation specified on the Consumer’s care plan. If transportation is provided, it MUST be documented by the attendant within the app. Documentation should state specifically what transportation was provided and where .I understand that I must contact my Consumer’s CDS Specialist immediately on the day in which it occurs if I am unable to document the reason within the app.8* I understand that I will not be paid for any shifts in which my location does not indicate I am at the Consumer’s home when clocking in or out unless it is for approved transportation and documented accordingly.9* I understand it is my responsibility to check the history within the mobile app to ensure that all recent visits are accurate and up to date. If any visits are not accurate or there are any other issues, it is my responsibility to contact my Consumer’s CDS Specialist immediately.10* I understand that the Mobile App may only be downloaded on one device and that must be my primary cellular phone that I use on a daily basis. The App may not be downloaded on the consumer’s or anyone else’s phone or device. I also understand that if I get a new phone and need to download the App on that device, I must notify my Consumer’s CDS Specialist.EVV Training and Timesheet Policies11* I understand that I am the only person that can utilize my access code and password to clock in/out. No one can clock in or out for me.12* I understand that I must contact my Consumer’s CDS Specialist immediately if I am unable to clock in or out for any reason.13* I have been trained on the EVV system and understand what I must do to clock in and out. I understand that I must use EVV for all shifts worked.14* I have been trained on how to complete a paper timesheet, if necessary, and understand that I must contact my Consumer’s CDS Specialist if a paper timesheet is used. I further understand that the timesheet must be submitted immediately. Any timesheets submitted more than 30 days past the date of service will not be paid.I, the above-named attendant, hereby acknowledge that I have received and understand this EVV Acknowledgment. I understand that the Consumer Directed Service funds are from State and Federal revenues. Misuse of these funds may constitute fraud. I understand that all suspected fraud will be reported to the State Medicaid Fraud Unit and/or the local prosecutor as necessary and appropriate.Signature*Date* MM slash DD slash YYYY Revised 11/29/2021NameThis field is for validation purposes and should be left unchanged.