--0000000000007a89220647fc0219 Content-Type: text/plain; charset="UTF-8" Content-Transfer-Encoding: quoted-printable Received. On Fri, Jan 9, 2026 at 4:24=E2=80=AFPM Ashley Alford wrote: > > > Commitment Client Yes or NO : No > > Client consent paperwork uploaded - Yes > > OT approved- NO > > > > HCL: Micah > > Office Milwaukee > > Regional Intake Manager: Emily L > > Caregiver Manager: Pat > > Client Success Manager: Ashley > > Referral Source: Care scout > > *Client Name:* Herman Langford > > *Client Address:* 8901 N 70th St, Milwaukee, WI > > Gated Community/Code/Parking Instructions: > > Home Phone: > > *Contact Person:* POC Montez # (414) 324-4784 > > Assessment Completed on: 12/5/2025 > > *Schedule:* Mon, Wed, Fri 10am- 2pm *NO Care the week of Feb3- Feb 8th. > CL will be in Houston TX for all of July- August. They would like service= s > transferred out of state during this time.* > > *Start Date:* 1/22/2026 > > Bill Rate: Private pay rate $36 CL has elimination period with LTCH John > Hancock- CareScout Rate Quoted 38.75 > > Client Narrative: *Care Match - CPE =3D C3; P2; E3-*Mr. Herman is a > retired history teacher who lives with his daughter Montez and her husba= nd > Wayne. Montez would like to utilize Mr. Herman's John Hancock policy for > LTCI, for an in-home caregiver. S Mr. Herman would benefit from > companionship care; and someone who can motivate him to stay active. > > > Ht:5'9 > > Wt: 175 > > Gender: Male > > Routine/Tasks > Mr. Herman will benefit from SBA with walking & transferring, he doesn't > use any assisted devices at this time. He will require HOA with (showerin= g, > meal prep/ serving) and is able to dress himself & complete many personal > cares with verbal cueing/ reminders. Montez obtained a YMCA gym membershi= p > for Mr. Herman & would like the CG to transport and chaperone him- he ma= y > have a personal trainer/ join a class at the facility. She is very > interested in our BCM- and keeping him engaged. We discussed our CG > activity bags with activities for cognitive and creative stimulation and > she was impressed. She says she has a few items at the home for cognition > like games but would love a proactive self starting CG who can motivate > him. She will be purchasing coloring books and craft items to keep him > engaged. Montez worries about Mr. Herman being up in his room all the tim= e > & is looking forward to an enthusiastic CG to motivate him and keep him > from being so withdrawn. > > *DL:* Yes > > *Car: *Yes > > *Cg preference*: Enthusiastic, high energy with the ability to use > redirection techniques. Someone who is not afraid to hear NO and try agai= n; > A caregiver with solutions and ideas to keep him stimulated, and engaged > during the shift. > > Cats: NO > > *Dogs/Breed:* Yes- kept in Kennel > > Smoking: NO > -- > > > > > > -- > > *Ashley Alford* > > CSM/ Caregiver Manager | TheKey > > Mobile: 414-704-3806 > > > > --=20 *Pat Echols* *Caregiver Manager* *414-964-8000* --0000000000007a892206