2019 Wiker Service Award Nomination Form
Do you know a Randall Residence employee who should be honored for their exemplary care and service? If so, take a few moments to fill out this form and explain how they do the following:
• Protect each resident's right to privacy
• Foster independence for each resident
• Treat each resident with dignity and respect
• Involve family and friends in care, when appropriate
• Promote the individuality of each resident
• Provide a safe, residential environment
• Allow each resident choice of care and lifestyle
• Enjoys taking care of the residents and lets that show to all they encounter
Name of Person Who Deserves This Recognition
What type of job does this individual do?
Resident Care Assistant
Location Nominee Works At
Randall Residence of Centerville
Randall Residence of Decatur
Randall Residence of Tipp City
Villa at the Lake
How do you know the nominee?
My loved one lives at the residence where nominee works
I'm a co-worker
Other-describe in space below
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