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Contract #68-2012 <br />Southern Home Care Services, Inc. <br />L. The Contractor will immediately notify the County when Protective Services Cases are <br />not staffed, when In-Home Aide workers are absent, and/or when any of the following <br />...occur: _ _ ._ _ _ _ __ <br />a. The client dies. <br />b. The client enters a rest home, nursing home, or hospital. <br />c. The client moves from the original address on the request. <br />d. The client refuses to accept the services or to comply with care requirements. <br />e. There are significant factors that affect the client or significant changes in a <br />client's situation. <br />Signature <br />Agency/Organization <br />~P_ GGC-{-l~ V e ~ i Y' 2 c't~ r <br />Title <br />~•~~- o~ <br />Date <br />• <br />(Certification signature should be same as Contract signature.) <br />• <br />Outcomes (06/04) Page 2 of 2 <br />