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5617 NW 7TH ST. MIAMI FL 33126-3216

Essential Caregiver’s Designation

EXHIBIT B

    I,

    designate

    as essential caregiver for



    In making this designation, I consent and understand that:

    • Visits by essential caregivers are subject to Residential Plaza’s policies and procedures and ability. to screen visitors and monitor visits.
    • Essential caregiver visits may be based on current facility conditions and may be limited to a minimum of 2 hours daily, based on the ability of staff to safely screen and monitor and the space to accommodate the essential caregiver visitors.
    • Residential Plaza will allow in-person visitation in all of the following circumstances unless the resident objects:
      - End-of-life situations.
      - A resident who was living with family before being admitted to Residential Plaza’s care is struggling with the change in environment and lack of in-person family support.
      - A resident making one or more major medical decisions.
      - A resident experiencing emotional distress or grieving the loss of a friend or family member who recently died.
      - A resident needs cueing or encouragement to eat or drink which was previously provided by a family member or caregiver.
      - A resident who used to talk and interact with others seldom speaking.
    • Essential caregivers will need to follow Residential Plaza’s infection control and education policies and procedures and agree to such. At no time will they be more stringent than those for staff and at no time required to submit proof of vaccination.
    • Essential caregivers must sign an acknowledgment of completion of required training and adherence to infection prevention and control policies.
    • Visits by a specific essential caregiver may be suspended for failure to follow infection prevention and control requirements or other related rules of Residential Plaza. At that time the resident or resident’s representative can designate a new essential caregiver.