The point of an internal audit is to find your own problems before a surveyor finds them, while you still have time to fix them quietly. Run this quarterly rather than annually, and run it on real files rather than on the version of your operation that exists in your head.
Pull a sample rather than everything. Three employee files chosen at random and three client records will tell you more in an hour than a full review you never finish.
On this page
Policies and procedures
- Do your written policies cover every service you currently deliver, and only the services you currently deliver?
- Does every policy carry an effective date and a revision date?
- Is there a record showing the policies were reviewed in the last twelve months, with a name attached to the review?
- If you changed a practice this year, does the policy reflect the change, or does it still describe the old way?
- Can a staff member find the current policy without asking you where it is?
Personnel files
- One file per employee, including anyone you treat as a contractor.
- Application, verified references, and signed job description on file.
- Criminal history and registry checks completed and dated before the first shift, not after.
- Required health screening documented per your policy and current state requirements.
- Orientation and required training documented with dates, topics, duration, and the trainee signature.
- Annual competency or performance review present for anyone employed more than a year.
Client records
- Signed service agreement and client rights acknowledgement.
- An individualised service plan that matches what your caregivers are actually doing in the home.
- Evidence of service delivery for the period sampled, in a consistent format.
- Documented reassessment or service plan review at the interval your own policy specifies.
- Any incident involving this client cross-referenced to your incident log.
Logs and corrective action
- Incident log present, complete, and current, with supervisor review recorded.
- Complaint log kept separately, with investigation and resolution recorded.
- For every incident or complaint that revealed a problem, a corrective action record showing what changed and whether it worked.
- Evidence that trends are reviewed periodically rather than only case by case.
How to score it
- Mark each line present, incomplete, or missing. Do not invent a middle category for things you believe exist but cannot locate, because a surveyor will score those as missing too.
- Anything marked missing in the personnel or incident sections is a first-priority fix. Those two categories generate the most findings and are the fastest to correct.
- Set a date for each fix and put it on your governance calendar rather than in your memory.
If you would rather not build this yourself
Audit Readiness Toolkit — $47
Four working documents for finding what is missing before a surveyor does. Built for Texas agencies that are licensed and want a concrete gap list in an afternoon.
Get the toolkit — $47Common questions
How often should we run an internal audit?
Quarterly on a small sample is more effective than annually on everything. Small, frequent reviews surface drift while it is still cheap to correct.
Who should run the audit?
Someone other than the person who created the records where possible. If you are a small agency and that is not possible, use a written checklist so the review is structured rather than impressionistic.
Related guides
Private-Pay Home Care Compliance in Texas: What Actually Gets Checked
Private-pay home care in Texas is licensed and surveyed. Here is what HHSC checks, which documents you must keep, and how to prepare before your first survey.
Corrective Action Documentation for Care Providers
How to document corrective action so it counts: root cause, the specific change, who owns it, the deadline, and the follow-up check that proves the fix held.
Policy and SOP Management for Care Providers
Version control, effective dates, annual review, and staff acknowledgement. How to keep a policy manual that matches what your agency actually does.
Get the free Texas survey-prep checklist
One printable page covering the records to check before a survey. Opens as soon as you enter your email.
Texas care operators only. Unsubscribe any time. Your address is never sold or shared.
ApexCare Governance™ provides operational documentation and educational guidance. It is not a law firm and not a licensed regulatory consultant. It does not provide legal advice, interpret regulations, certify compliance, or guarantee any licensing or inspection outcome. Verify all current requirements directly with Texas Health and Human Services.