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Captures employee and consumer details, dates of work, start/end times, pay rate, service codes, service location, and total hours submitted. Includes admission-to-hospital restrictions, required certification and signature fields, submission timing aligned to payroll schedules, and notes on avoiding blank or third-party sign-offs. Provides a program and service-code pay-rate and employer-tax matrix, plus EVV applicability conditions and contact information for questions.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":21,"@type":70,"position":76},"https://docshare.wps.com/template/invoices/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/evv-and-non-ddsd-timesheet-january-2022/242997/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/evv-and-non-ddsd-timesheet-january-2022/242997.png","ImageObject",442,249,{"name":88,"@type":89},"Melati","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-17","2026-09-12",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What does “overtime exempt” mean on this form?","Question",{"text":109,"@type":110},"Overtime exempt means the employee should not be paid overtime wages. Not overtime exempt means the employee should be paid overtime wages.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"When can services not be paid for a participant?",{"text":114,"@type":110},"Services cannot be paid while the participant is admitted to a hospital or nursing facility.",{"name":116,"@type":107,"acceptedAnswer":117},"What are the rules for submitting the time sheet electronically?",{"text":118,"@type":110},"Electronic time sheets must be received by 12:00 PM on Monday of the payroll week. Late time sheets are processed for the next regularly scheduled program pay date.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},242997,1791060995,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":20,"category_name":21,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":9},962085570644,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Is Employee Exempt from Overtime Payments?  \n\n| | Yes (Overtime exempt means should not be paid overtime wages) | | No (Not overtime exempt means should be paid overtime wages) |\n| --- | --- | --- | --- |\n\nARIS Solutions Time Sheet  \nEMPLOYEE NAME:   LAST FOUR DIGITS OF SS \\#   CONSUMER NAME:   AGENCY    \nDo you live with the person you provided care to?  Yes  No  \nWas the Consumer admitted to a hospital or nursing home during any of these dates? Yes  No   \nIf YES, indicate the dates the Consumer was admitted to and discharged from the hospital or nursing home   \nWill this employee continue to work for you? Yes No  \nIf no, why not:  Quit  Fired  Laid Off Effective Date:    \nSERVICES CANNOT BE PAID WHILE PARTICIPANT IS ADMITTED TO A HOSPITAL/NURSING FACILITY Program Consumer Receives Supports from:  \n\n| | Adult Family CareRespite | | Choices for Care (CFC) | | CFC-Moderate Needs | | Attendant Services Program (ASP) or PDAC |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n| | Children’s Personal Care Services | | CFC—Flex Choices | | Family Managed Respite | | Brain Injury Respite |\n\nPrograms highlighted in blue) may require EVV depending on where the service is provided, or the employee lives  \n\n| Date | Start\u003Cbr>Time | A\u003Cbr>M | P\u003Cbr>M | End\u003Cbr>Time | A\u003Cbr>M | P\u003Cbr>M | Pay Rate | Service Code\u003Cbr>(See Back for\u003Cbr>Codes) | Location of Service (Consumer’s Home or else Community) | \\# of Hours\u003Cbr>Worked |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n|  |  | | |  | | |  |  |  |  |\n| Total Number of Hours Submitted |  |  |  |  |  |  |  |  |  |  |\n\nI (below) certify, under the pains and penalty of perjury, to the best of my knowledge, that the dates, start and end times, and hours provided on this form are true, accurate and complete. I understand that submitting an inaccurate time sheet may result in termination of the employer and/or the employee from this program and may result in civil and/or criminal penalties.  \nEMPLOYEE SIGNATURE  DATE  PRINT EMPLOYER NAME   DATE  EMPLOYER SIGNATURE   EMAIL/PHONE    \nTime Sheets must be submitted according to the payroll schedule. Electronic time sheets must be received by 12:00PM on Monday of the payroll week. Late time sheets will be processed for the next regularly scheduled program pay date.  \nEVV and non-DDSD Timesheet (January 2022)  \nDO NOT SIGN A BLANK TIMESHEET OR SIGN A TIMESHEET ON BEHALF OF SOMEONE ELSE  \nThis timesheet is not for Developmental Disabilities Services (DS Waiver) Supports  \n\n| Program | Service | Service Code |  | Minimum Rate* | Employer Tax* |\n| --- | --- | --- | --- | --- | --- |\n| Adult Family CareRespite | Respite (Hourly) | AFCR |  | $12.80/hour | 13.09% |\n|  |  | AFCR |  | $204.80/day | 13.09% |\n|  |  |  |  |  |  |\n| Children’s Personal Care Services | CPCS Personal Care | Personal Care |  | $12.80/hour | 12.4% |\n|  |  |  |  |  |  |\n| Choices for Care (CFC) | Personal CareConsumer | Personal Care |  | $12.80/hour | 13.09% |\n|  | Personal CareSurrogate | Personal Care |  | $12.80/hour | 13.09% |\n|  | Companion CareConsumer | Companion |  | $12.80/hour | 13.09% |\n|  | Companion CareSurrogate | Companion |  | $12.80/hour | 13.09% |\n|  | Respite CareConsumer | Respite |  | $12.80hour | 13.09% |\n|  | Respite CareSurrogate | Respite |  | $12.80/hour | 13.09% |\n|  |  |  |  |  |  |\n| CFC—Flex Choices | Flexible Choices | Flexible\u003Cbr>Choices |  | $12.80/hour | 13.09% |\n|  |  |  |  |  |  |\n| CFC—Moderate Needs | Moderate Needs | Moderate Needs |  | $12.80/hour | 13.09% |\n|  |  |  |  |  |  |\n| Family Managed Respite (FMR) | Respite (Hourly) | Respite ","cbCaiekDJ5pA5tWq","https://ap.wps.com/l/cbCaiekDJ5pA5tWq","pdf",433458,"English","# ARIS Solutions Time Sheet\n## Overtime Exempt or Not\n## Employee and Consumer Information\n## Admission and Work Continuation Rules\n## Service Programs and EVV Applicability\n## Weekly Submission and Certification\n## Program Service Codes, Minimum Rates, and Employer Tax","[{\"question\":\"What does “overtime exempt” mean on this form?\",\"answer\":\"Overtime exempt means the employee should not be paid overtime wages. Not overtime exempt means the employee should be paid overtime wages.\"},{\"question\":\"When can services not be paid for a participant?\",\"answer\":\"Services cannot be paid while the participant is admitted to a hospital or nursing facility.\"},{\"question\":\"What are the rules for submitting the time sheet electronically?\",\"answer\":\"Electronic time sheets must be received by 12:00 PM on Monday of the payroll week. Late time sheets are processed for the next regularly scheduled program pay date.\"}]","EVV and non-DDSD Timesheet - January 2022 | PDF",1789198138]