Easter Seal SC
In-Home Provider Agreement
Roles and Responsibilities of the In-Home Respite Provider.
1. Provide a safe and appropriate environment at all times for the child(ren) in your care. Respite providers must
adhere to safety regulations which ensure the safely of respite clients, parents, and their property. Providers must
also use universal precautions when appropriate to protect the health of the client and themselves.
2. Report to your respite care appointments on time or notify parents/guardians and Easter Seals SC staff at least
24 hours in advance if they must cancel a respite appointment. You may be at risk of being designated as
temporarily or permanently inactive as a Respite Provider if you are habitually late to respite appointments or
cancel with less than 24 hours notice.
3. Confirm a scheduled respite appointment 24 hours in advance to ensure the parent’s plans have not changed.
Notify Easter Seals SC staff when a parent is not at home or turns you away at the door for a scheduled respite
4. Providers must be in agreement with parent on which children are under the provider’s supervision during respite
care, keeping in mind that typical siblings who have aged out are not the responsibility of the respite provider.
5. Providers should not do housework or perform any tasks that are not related to the direct care and supervision of
the child(ren) in care. If a parent is also a family child care provider, respite care may not be provided during
hours of operation of that facility.
6. Providers may not provide more that forty (40) hours of respite care to a single family per month through this
program. Please remember, there may be other providers working for the family in which case you may not be
working the full 40 hours that the family is using.
7. Providers are required to report complete, legible, and accurate information on their attendance sheets,
application, and all other documents related to Navy EFMP Respite Care. You are at risk of being designated as
permanently inactive as a provider if you provide false information.
8. All providers are required to maintain mandatory certification and attend required trainings. Providers must attend
two (2) designated professional developments trainings in their first year. Each subsequent year, providers are
required to complete four (4) pre-approved trainings on topics related to special needs, disabilities, heath &
safety, or child development. Providers must attend at least one training every six months. Andy violation of this
policy will result in a provider being designated as temporarily inactive as a provider until training requirements
are met. If a provider habitually is out of compliance with training requirements, they may be designated as
permanently inactive.
9. Respite Care must be provided for a minimum of two (2) hours each appointment.
10. Respite Care cannot be scheduled more than once per day with the same family, i.e., no split shifts.
11. Respite Care may not take place in the home of the provider unless it is a licensed family child care home or
12. Providers must be instructed on the proper care required for each child before providing care. This includes the
use of any adaptive apparatus or other necessary accommodations.
Courtesy of YMCA Childcare Resource Service, San Diego, CA
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Easter Seal SC
In-Home Provider Agreement
13. Providers must obtain written instructions and permission from the parent before administering any medication.
Parents complete the Authorization for Medication Administration form. Providers may not administer any
medication that is not in its original container. Providers may only administer
the medication to the child indicated on the label. Record all medication provided on the Medication
Administration Log for that family and submit monthly to Easter Seals SC staff.
14. Providers must have the emergency information and medical release for each child being cared for AT ALL
TIMES when providing respite services.
15. Providers may never transport children unless using public transportation. The only individuals authorized
to transport children in personal vehicles are parent/guardians and individuals listed on the emergency release
form. Any violation of this policy may result in provider being designated as permanently inactive as a respite
care provider.
16. Providers are expected to maintain a professional demeanor and relationship with all members of the families with
which they work, at all times. This includes maintaining appropriate boundaries, maintaining client confidentiality,
remaining neutral in al family disputes, only providing care to the authorized children in the family (i.e., no older
siblings, family friends, children of respite care provider, etc.).
17. Providers may not, under any circumstances, bring another person or pet with them to a respite care
appointment. This includes children, relatives, friends, or other acquaintances. Any violation of this policy may
result in a provider being designated as permanently inactive as a respite care provider.
18. Providers will only be referred out based on availability, experience, service area, etc. Providers are not permitted
to request additional compensation from families during respite appointments. Navy EFMP Respite Care is
designed to meet the needs of the families served.
19. Providers are prohibited from unauthorized possession of, use of, or misappropriation of property, equipment or
funds of respite clients is strictly. This includes use of electronic devices such as family computers or cell phone
during respite services.
20. Providers are prohibited from consumption, being under the influence or in possession of alcohol or drugs while
providing respite care services. Any use of alcohol or drugs will result in a provider being designated as
permanently inactive as a respite care provider.
21. Providers must understand that Easter Seals SC staff is required to monitor In-Home respite providers and
conduct quality assurance observations during times that respite care is scheduled. Providers in their first year
will be observed every other month. Provider in their subsequent years that remain in good standing will be seen
on a quarterly basis. The purpose of the observation is to monitor the quality of care and provide technical
assistance and resources. Observations will be unannounced to the provider.
22. Providers must return calls and emails from parents and Easter Seals SC staff within 24 hours. Providers must
also sign and return all notification letters, forms and other documents by the date requested.
23. Providers must notify Easter Seals SC staff in advance of any periods of inactivity in providing care of more than 5
business days such as vacations or care for a family member.
24. Providers are required to notify Easter Seals SC staff and all authorized parents of all changes to address and/or
contact information within 48 hours of the change occurring.
Courtesy of YMCA Childcare Resource Service, San Diego, CA
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Easter Seal SC
In-Home Provider Agreement
25. Providers are encouraged to notify Easter Seals SC staff of any problems or concerns related to the respite care
being provided.
The undersigned shall indemnify, defend, and hold harmless the Easter Seals SC, Child Care Aware® of America, the
United States Navy, and the United States Government, from and against any and all claims, demands, suits, liabilities,
and judgments, including attorneys fees and claims for bodily injury or death, arising from services rendered or for
facilities provided with the operation of EFMP Respite Care.
This list is not intended to be all-inclusive and does not prevent the Easter Seals SC from counseling or designating a
provider as temporarily or permanently inactive for additional actions which violate agency standards for conduct.
I have read and understand the roles and responsibilities of an In-Home Respite Provider and the reasons for removal
from the program. I agree to comply with these regulations and policies and I have received a copy of this Provider
Print Name of Respite Care Provider
Courtesy of YMCA Childcare Resource Service, San Diego, CA
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